August 2014 - Health Literacy Lab

Scatology of a Health Communication: so which is it? “Poo” or “Poop”?

Posted on August 23, 2014 by Public Linguist

For those of us who burrow in similar holes trying to produce easier-to- understood language to explain health information, one place we find ourselves provincially tongue tied is when discussing any and all things scatological.

excrement stool

secretions solid bathroom waste

bowels waste

defecation crap

The committees we’ve convened to decide how to say what we mean are legend.

Ebola has us at it again.

According to WHO, (my highlighting/coloring)

“Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids.”

And in their Q/A they state:

“Infection occurs from direct contact through broken skin or mucous membranes with the blood, or other bodily fluids or secretions (stool, urine, saliva, semen) of infected people.”

A few days ago a talented colleague who strives to communicate health clearly to a broad national audience shared a statement her organization had settled on:

“You can get Ebola by touching the vomit, blood, spit, sweat, pee, or poop of someone who is sick with or died from Ebola.”

YES! Finally The frankness, the downright street worthiness of that word “poop.”

Ah, but over that second cup of coffee, when my linguistic component kicks in – which is it –

Poo or Poop?

Isn’t poop more used as the verb.

As in, mother to child, Did you poop?

And isn’t poo more the noun. “Did you have a lot of poo?”

Bottom line – which is more appropriate to use for understandability. Would poop offend less than poo?

A dictionary search shed little light.

MacMillan Dictionary reports thus:

poop noun

the act of passing waste from your body when you go to the bathroom. This word is used especially by and to children.”

The OED doesn’t list the word “poo” but places poop’s origin in the 1930s and define it as “to defecate” as in “take a poop”.

A wasteful linguistic exercise? Not really.

I’m more than curious about this specific word choice.

Which do people prefer?

Is there a chance some readers/listeners would be offended? Think we’re being infantilizing?

Do we care if the result is that the larger public gets the message?

HPV information worth checking out

Posted on August 18, 2014 by Public Linguist

I write a lot about the mounds of health information that fails to communicate clearly to the majority of the US public – not highly science and health literate and who labor to read well.

When NYC City Council Speaker Melissa Mark-Viverito tweeted last night that she had been diagnosed with “high risk” HPV, I knew that many women would not know exactly what this meant. But social media would spread the word and women would want to know.

My google search hit on the CDC Fact Sheet first, and so I took a look.

The language and text elements used here result in a message that is meaningfully useful to a broad audience of readers.
Excerpt of first paragraph –

“HPV is the most common sexually transmitted infection (STI). HPV is a different virus than HIV and HSV(herpes). HPV is so common that nearly all sexually active men and women get it at some point in their lives. There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening.”

The current CDC HPV Fact Sheet has a number of things to commend it:

generally easy vocabulary ( 6th-8th grade) with no medical jargon
mostly simple and compound sentence structures – avoiding disjointed, staccato-like simple sentences
helpful repetition of the key topic noun so people know what is being referred to – good coherence
a thoughtful strategy –

normalizes HPV at the start instead of striking dread into readers. Dread predisposes many not to read on
clearly distinguishes HPV from HIV and HSV within the first two sentences – orthographically ( referring to the visual array of the abbreviated letters) – helping readers not confuse these medical acronyms.

To balance my enthusiasm, it’s probably time to steel myself and take a look at what the SANEVAX folks have brewed up.

How to fumble a simple hazard warning about NYC beaches

Posted on August 14, 2014 by Public Linguist

Another Installment of

Language Acting Badly

Those of us who’ve signed up to receive text alerts from the impressive NYC system Notify NYC, know we open ourselves up to a wide range of warnings, notices, and concerning information that can intrude at any time day or night. (Let’s not go there)
Some days a “Silver Alert” about a missing elderly man with dementia. Other times it’s a “Heat Advisory” warning me to stay hydrated.

Today it was a text about the condition of NY Beaches 2 days after the NY area were deluged with over a foot of rain that sluiced tons of runoff into the beaches.

The text from Notify NYC read:

“The advisories have been lifted”!

How high?
Lifted off of what?
Is it like “lifting your voice” – making it higher and louder? (OED primary definitions applied)

“lifted” here is a word used for legal purposes, not the right word for public consumption.
BTW, notice the passive verb that further complicates this simple message.

A Rewrite
The NYC Dept. of Health reports that all NYC public beaches are now safe for swimming. There are NO beach advisories. …

How useful is this ubiquitous Ebola graphic?

Posted on August 5, 2014 by Public Linguist

I’d say the US broadcast media and online sources have shown restraint in the visual aids they’ve used covering Ebola this past week. Avoiding the horribly gory photos you can easily uncover on a Google search, in favor of health workers in HazMat suits and maps of the affected African regions.

One visual that’s been ubiquitous is this one:

Sometimes the caption just says “Ebola virus”

And other times, as in the Daily News today , “Saudi Arabia is testing a man for suspected Ebola after he returned froma trip to Africa with a hemorrhagic fever.”

On my way down in the elevator this morning to walk Tilly I asked a neighbor what she thought the image was.

She wryly remarked above her steaming coffee – “some poor sperm having trouble.”

For decades the NSF’s survey of public understanding of science shows that roughly 80% of the public has very low science literacy I would say your’e wasting precious media real-estate with this one.

Ebola Infographics

Posted on August 3, 2014 by Public Linguist

A friend from Down Under responded to my hand wringing about the unnecessary difficulty of the CDC’s explanation of Ebola on its website.

She kindly shared an ABC News (AU) piece that does a far better job explaining some of the basic information about Ebola to the public.

Above visual “Ebola Transmission Visual”

The overall lay out of the information is user friendly – much less crowded and intimidating than the CDC page.
What really caught my eye were the visuals ( Infographics ) about Transmission , and interactive Affects on the Body, and for those inclined to read charts, a chart.

The language used on the site is not anywhere close to the high barrier grade 13-14 reading level the CDC language uses. But I couldn’t help from fiddling with it a bit. A few tweaks here and there would make this an even more accessible piece.

Original	A Rewrite for more universal comprehension
What is Ebola, and how does this highly contagious and deadly disease spread?	[vocabulary] What is Ebola and how does this very contagious and deadly disease spread?
First discovered in 1976, the virus has periodically spread through parts of Africa, killing thousands in the process.	[activate the verb and flip the order of info] The virus was discovered in 1976 in Africa. From time to time Ebola starts and spread in parts of Africa and kills thousands of people as it spreads.
There is currently no vaccine, and due to its fast onset and horrific symptoms it has become one of the world’s most feared diseases.	[clarify the reference(Ebola); unpack an overly complex sentence into 2 sent.] There is no vaccine for Ebola virus. It makes a person sick very quickly and the sick person suffers very horrible symptoms. For these reasons Ebola is one of the world’s most feared diseases.
How does it spread? There are five strains of Ebola: Zaire, Sudan, Tai Forest, Bundibugyo and Reston. The Zaire strain, which is involved in the latest outbreak, is the most lethal with a fatality rate of up to 90 per cent.	How does it spread? There are five strains of Ebola: Zaire, Sudan, Tai Forest, Bundibugyo and Reston. [simplify sentence by losing the embedded clause (which is involved…..] The current outbreak (or the outbreak that is happening now) is the Zaire strain of the Ebola virus. Zaire is the most lethal *(deadly)* strain and 90% of the people who get sick with this strain die.
Humans can catch the virus from animals through close contact with infected animals’ blood, secretions, organs or other bodily fluids.	OK
The virus is thought to reside within the region’s fruit bat population, with the bats carriers of Ebola, but unaffected by it.	[Voc; activate verbs] Scientists think the virus lives in the fruit bats. And even though the bats carry the virus they do not become sick.
The bushmeat trade (the catching and eating of wild animals, including primates such as gorillas and chimpanzees) is thought to play a role in outbreaks of the disease.	[avoid nominalized verbs – “the catching”; activate] Some people in the region catch and eat wild animals, including gorillas and chimpanzees (called “bushmeat”). Experts believe this is part of the way the virus spreads

From what I’ve always read and found in my own research most people are not offended when they are presented with clearly written information so long as they can easily take a deeper dive if they choose to – find more elaborated or technical information if that’s what they want.

Has this been your experience?

Do you think health communicators know some of the basic rules – for example, using more active verbs, and unpacking multipli-embedded sentences? If they do, why don’t they use them?