6th Annual Colorado Health Literacy Coalition Conference:
I am speaking followed by the renowned health literacy expert, Janet Ohene-Frempong.
Agenda
Abstract of my talk:
Author: Public Linguist
When curating health information for the public may be dangerous to their health
Monique McCollum and her colleagues at Univ of Colorado Hospital are hosting their 6th conference online.
They’re good folks, thinking about good things and….broad minded – witness they invited me!!!
Preview of my talk
Covid is, what I call, a “concentrated encounter” – a time of extremely distilled significances. In such times the submerged fault lines of social inequality now are seen as chasms.
When it comes to how we curate (gatekeep) health information for low health literate folks, how are we not perpetuating a great divide by limiting vocabulary, using stilted sentences, or even forsaking print for pictograms?
- How is there not just a wiff of classism or even racism in how we’ve defined people’s competencies?
- How do we propose the path we’ve taken is going to help level the playing field between experts and all the rest of us?
Hope you can join us. 🙂
Lists of forbidden health terms!!!!
A reader asked me to give some alternatives to deleting more complicated or technical words and simply substituting easy ones – the subject of yesterday’s post.
Instead of creating a dossier of words you “shouldn’t use” try any of these:
Original Sentence
“The flu can be transmitted easily from one person to another.”
Deletion – Substitution
“The flu can spread easily from one person to another.”
1. Use parenthesis (or other kind of call out)
The flu can be transmitted (passed) from one person to another.
2. Create reference and reinforcement across sentences (cohesion)
a. The flu can be transmitted from one person to another. It is easy for one person to give the flu to another person.
b. It is important to stay home if you have the flu. Flu spreads easily. The flu can be transmitted from one person to another.
3. Activate sentences
A person can transmit the flu to another person. If you have the flu you can easily pass it to another person or many people.
4. Prompt for active reading through guessing & inference
a. If you have the flu you can transmit it to other people and they can get sick too.
b. The postal worker went to work when he was sick. He transmitted the flu to his co-workers. He didn’t know he could give them the flu.
When we analyze sentences in isolation or “test” materials by having readers read one sentence at a time and “tell me what that means” that’s when we get stuck on the idea that every word has to be comprehended.
Liberate yourself (and your audience) from word for word reading!
“The flu can be transmitted easily from one person to another.”
Deletion – Substitution
“The flu can spread easily from one person to another.”
The flu can be transmitted (passed) from one person to another.
a. The flu can be transmitted from one person to another. It is easy for one person to give the flu to another person.
A person can transmit the flu to another person. If you have the flu you can easily pass it to another person or many people.
a. If you have the flu you can transmit it to other people and they can get sick too.
You’ll be amazed how empowering it is to let language do what it’s meant to do.
And who knows, you might start jettisoning that dossier of forbidden words.
You will be far happier and your readers too if you keep in mind how people really read (even less able readers):
And who knows, you might start jettisoning that dossier of forbidden words.
You will be far happier and your readers too if you keep in mind how people really read (even less able readers):
We read and scan,
We read, skip and guess,
We read back
We read and learn
A Health Literacy Prescription To Perpetuate Inequality
If you know my work, you know that I think a lot about, what I call, the Simplicity Complex – examining the upsides and the downsides of simplifying (often over-simplifying) the language used to communicate about health. The most persistent recommendation from researchers and practitioners in the field of health literacy – simplify the words….and sentences in your message.
What if the complexity of health information, science, society and its disparities, in the first half of the 21st century, requires more than simple representations of science, medicine and decision making?
Lately, I’m becoming less subdued in my criticism of all things simplified. Chalk it up to the inability of millions to understand ( as we intended it) the simple message – “Wear a Mask”!
Here’s the most current example of the ubiquitous advice from people working in health literacy to SIMPLIFY.
This particular online influencer in health literacy has been fairly liberal in dispensing advice to “stop saying “hypertension”, or “cardiovascular health”, or “novel virus” or “contraception”….You get the idea.
Given Covid and all the talk about “transmission” they’ve reprised (brought back again) an old post about why you should substitute simpler words for more complicated words.
In their crosshairs this time, the word, “transmit.”
They say the word is “straight out of a sci-fi novel or ham radio how-to. And the related noun, “transmission,” is more hot rod than Hot Zone.”(Forgive my low movie/media literacy here. I don’t even get what the the second sentence is alluding to.)
Their evidence, witness the unruly sentence:
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“The flu can be transmitted easily from one person to another.”
The untangled…..
“The flu can spread easily from one person to another.”
They claim that there is no reason to use the verb “transmitted” when the world is full of simple words like “spread” or “pass.”
No reason indeed? Well …….I can think of a few.
Reason #1:
While it’s true that “spread” or “pass” might be easier to read in an isolated sentence, a near universal reading/listening strategy we all use is “skipping and guessing.” (Check out Jean Berko-Gleasons’ fun linguistic Wugs experiments with (1958). By 4 or 5 years old kids begin to work with words they don’t know. That’s how we become active readers and listeners, and how we figure out what new words mean.
Reason #2
As language users we comprehend written and spoken language, in large measure, as a result of things we do across sentences/utterances (Olson, 1977 , 1994 ; van Dijk, 1977 ;van Dijk, 2001 ), not what we read in isolated sentences.
Reason #3
We use a wide range of skills to decode and make meaning, including expectations for the message and the topic, our motivation, the context, our past experience, language comprehension and trust in the messenger, just to name a few. Are we really saying that these things aren’t at work in the lives of less able readers?
Reason #4
Reading and linguist research shows that words, ambiguous in isolation, are decodable when they appear embedded in rich context. A primary reason—decoding is an active process that engages the reader.
In a previous post, “We are not all in this together: public understanding of health and science in the time of COVID” I tried to put forth reasons why we should really stop and think about what we’re doing when we routinely gatekeep every bit of health information and remove any “complexity” in favor of simple words, simple thoughts. The downsides are many. Here are three top of my mind.
Routinely targeting more complex words and replacing them with simple words:
- assumes that readers/listeners can’t figure things out – become more active, confident readers who, all the research shows, are more engaged with the information and thus learn more from it;
- is communication by subtraction. It distills out basic health and science concepts that are fundamental to being health literate
- takes the focus ( and responsibility) off writing well constructed, cohesive sentences that support each other and assist the reader to make meaning.
The blogger’s advice concludes (in bold):
“When writing about infectious diseases, skip “transmit” and use “spread” or “pass” instead! (When writing about radios, aliens, or cars, it’s up to you.)”
The way that I see it, boundless simplification of health messages is an undertow we should be very wary of. If after 30 years, we don’t stop to interrogate this popular strategy we run the real risk of recapitulating inequity and denying access of many to the information commons.
The goal should be to develop new ways to clarify and communicate health information and advance public health and science literacy.
We are not all in this together: public understanding of health and science in the time of COVID
Christina Zarcadoolas, PhD
June 8 2020
June 8 2020
Ask adults in the US if antibiotics kill viruses or bacteria and many will respond incorrectly. As for naming the steps in the scientific method half are in the dark. And probe the purpose of a control group in a new drug’s development and you’re likely to get blank stares from half the population. Less than 25% understand what it means to study something using the scientific method. Less than 1/3 of the population is science literate. Trust in science is also fluid.
(Science & Engineering Indicators 2018 https://www.nsf.gov/statistics/2018/nsb20181/report/sections/science-and-technology-public-attitudes-and-understanding/public-knowledge-about-s-t )
It’s not a stretch to conclude that the public is showing up unprepared to take in, understand and use the current science and health information experts and the media are using to talk about COVID19 – chain of transmission, modeling, flattening the curve, social distancing, high throughput vaccine development, antibody testing and immunity passports.
I didn’t write this piece in 2005, in 2009, or in 2014. Maybe because those complex emergencies – Hurricane Katrina, H1N1 the Ebola outbreak – were shorter lived, the public misunderstandings had less time to play out on TV and social media. And, public health’s focus quickly defaulted back to the perennial issues – chronic disease, obesity, smoking, STIs, mental health. We all moved on.
But this pandemic is very different. I do not recall a time in my professional life studying public understanding of health and science when it has been more important for everyone to get engaged and try to understand some of the science and do so while we are simultaneously witnessing science and scientists aggressively diminished by powerful influencers turned snake oil peddlers and conspiracy theorists.
The changing calculus of this pandemic is being scratched out in chalk marks. The science is dynamic and uncertain. So too the attention, understanding and staying power the public has. I listen endlessly to TV coverage, social media and zoom-bounded sessions with friends and colleagues as we try to string together pieces of often-conflicting messages. Should we wear facemasks? How does social distancing really work? Can it work if some don’t practice it? Does having antibodies mean we are immune to COVID? When can we open the country up again? Will there be a second, deadly wave?
While many of us may not need or want to understand what Dr. Fauci means when, during a White House Task Force Meeting (4/17/20), he reports that a recent virology study sequenced the virus gene and its mutations in bats and confirmed that the virus was an instance of zoonosis. But it’s likely we do want to understand what Dr. Birx means when she says: [We want to have a test] that is efficient. To let people know who has been positive or immunity. That is critical to epidemiologists and public officials, to know what the penetrance of a virus was in a community when all you’re seeing is the serious cases and testing the most symptomatic. (Briefing, 4/10/20)
Or
The antibody piece is critical, as you described, because at this time, we can’t – if we have – let’s say asymptomatic status is inversely – symptomatic status is inversely related to age, and so the younger you are, the more likely you are to be asymptomatic: We have to know that because we have to know how many people have actually become infected.
War, famine, tsunamis, emerging infectious diseases, pandemics. Complex emergencies always foreground health disparities and inequities. Of the more than 50,000 dead in the US, blacks and ethnic minorities are disproportionately impacted. Despite the surprise among some politicians, it’s our ongoing societal shame. Enfolded in this fault line is another deadly fissure. It is the persistent gulf between those who can engage with and understand some of the complex, conflicting and changing health and science information about COVID 19, and all the rest who can’t.
Low Health and Science Literacy
In the early 90s, as a result of the growing awareness of the literacy divide, public health experts prescribed a “prescription to end confusion” – advocating for developing “linguistically and culturally appropriate” health information, especially for the low health literate. Essentially they called for simplifying the complex language of health. The roots of this approach are found in English as a Second Language (ESL) instruction of the 70s and early 80s. Using health literacy principles became inseparable from efforts to “simplify”, make information “easy-to-read” and present in “plain language”. The popular wisdom – simple information will yield improved health literacy, and thus improved health behaviors and better health outcomes.
Over the years my work has involved reviewing lots of health information to determine readability and usability. Looking at these simplified texts as much I have, I’ve seen a growing pattern of minimal or non-inclusion of basic science concepts and information. Much of this overly simplified information has little ability to prepare the public to better understand and take actions in the face of complex health and especially a complex emergency like COVID19. (I’ve written about this at length elsewhere: The simplicity complex: exploring simplified health messages in a complex world, Health Promo Intl 2010).)
Either because public health messengers feel that it’s too complicated for people or they don’t think people are interested enough, there is a general stinginess with the science and the “why” behind health recommendations. As I hope to demonstrate in the examples below, simplification as commonly practiced in public health, especially for low health literacy audiences, is communication by subtraction and substitution. It distills out basic health and science concepts that are fundamental to understanding complex emergencies.
The following are three common weaknesses of simplification. They warrant reassessment, asking, can this message truly prepare the public to understand and make informed decisions in the face of a complex emergency such as COVID 19?
1. Poor writing: This first example demonstrates the dominant methods used to “simplify” a text/message: use simple vocabulary in simple sentences that are one line in length. Use a readability formula to check the reading level.
These sentences may be “simple” on the surface but they put real demands on the reader. The staccato of these five disconnected statements would strike any fluent reader as odd and unsatisfying. This type of writing runs counter to accepted reading and information processing theory and practice. In this short text there is just not enough information, stepping stones, to make good inferences. It’s like giving someone a puzzle and saying “Here you go. You figure it out.” Yet its format is ubiquitous, especially among those writing for low literacy and low health literacy audiences.
Reading involves making meaning across sentences and paragraphs. A well-written group of sentences helps the reader make those connections and make meaning. We don’t read an informational text such as the one above as if it were a page from telephone book. At minimum these five sentences could be reimagined as:
Vaccines protect us from many kinds of illnesses like measles, polio and the flu. But right now there is no vaccine for the virus called Coronavirus. (And) we can’t use antibiotics to fight Coronavirus because antibiotics do not kill viruses. Antibiotics kill bacteria. So doctors are working to develop (make) a vaccine but this could take a year or more.
2. Gatekeeper Choices
All health communicators/educators curate the information they produce for their audiences, making decisions about what to leave in and what to take out. Developers of messages for low health literacy and low literacy audiences often are heavy handed, choosing to delete the very information that would teach the consumer about science and advance health literacy. Such a deletion decision is evident in the following post by a social media influencer in health literacy, regarding COVID:
Ditch “novel.” Normally, we might swap “novel” for “new” in plain language materials, but “the new coronavirus” sounds a bit like a shiny new car. And at this point, COVID-19 doesn’t feel so novel anyway.
In the context of the pandemic, and all emerging infectious diseases more generally, the words “new” or “novel” have great significance and import. We would want a health consumer to learn that “new/novel” signals important ideas: people don’t have immunity (a way to fight this disease well); scientists will be learning a lot about the virus and therefore the known science will be changing a lot, there is no vaccine etc.
Think about it. It’s ok to introduce Sesame Street audiences to ”coronavirus” and “Covid 19” (CNN Sesame Street Town Hall on Coronavirus)
but “new/novel” would confuse an adult who may read poorly or have low health or science literacy?
3. Prescriptive/Directive Messages
Akin to omitting foundational information, you often see public health rely on basic hygiene messages. These messages use graphics/illustrations and minimal text. Below are two examples. The first, from H1N1 (2010), and the second, COVID 19.
There is every reason to communicate clear, direct risk and prevention messages. It is a major goal of public health. I recall during the Anthrax incident of 2001 it took only one short message for me to immediately change my behavior – “Do not microwave your mail.” These posters are excellent examples of this standard hygiene message. Disseminated widely, they have staying power. However, often what is not given as much attention however, is follow-up messaging about the “why” of each of these directions. For example, why should I throw the tissue away? Why shouldn’t I touch my face? Currently social distancing is proving to be a thorny behavior to get many Americans to adopt, and part of the problem may be that they do not understand the “why” – the transmissibility of this virus.
There are no doubt good, highly readable examples of simplified health messages. These are the product of good writers, well informed about their content and target audience. But that’s not what I’m writing about in this piece. Poorly designed simplified messages have contributed to a dangerous double jeopardy. Too much of “simplified” health information is not letting people in on the story. The commons is not a place for them. Presented with a diet of this “simplified” information has created a situation where at-risk audiences cobble together sound bites from mainstream media, politicans, social media and pseudoscience then reinforced by their peers, all picking over the same sub-standard information.
This will never be sufficient to engage more of the public with how to respond to a complex health issue like a pandemic. Why should I persist with social distancing if this is just like the flu? (Public health officials missed the opportunity to strongly reinforce how flu is. Tens of thousands of people still die every year because of seasonal flu and we have a vaccine! If I don’t understand anything about how “efficient” this virus is, why should I wash my hands so much? If I don’t have some working idea of what antibodies are I can’t understand why my state won’t open back up until we have proper testing.
This prolonged, tragic pandemic has many in expert positions reassessing and reimagining a post-pandemic world. Boundless simplification of health messaging for the public is an undertow we should be wary of. Un-interrogated it has the real risk to recapitulate inequity and deny access of many to the information commons. The goal should be to develop new ways to clarify and communicate health information and advance public health and science literacy.
Author and physician Reid Wilson, Epidemic: Ebola and the Global Scramble to Prevent the Next Killer Outbreak, reflected on what occurred during the Ebola outbreak and how it relates to today’s Covid19 pandemic. He discusses the powerful example of how people in West Africa changed their burial habits during the Ebola outbreak. Liberians began cremating their dead, changing a thousands year old cultural burial tradition. They did this in order to protect themselves and their community. Reid connects this to Covid19:
“People are intelligent. And if you give them the proper information on how to protect themselves they will go as far as to change the practices that their culture has used for of a thousand years in order to protect themselves in the short run from a virus. That tells me we have to put a premium on disseminating intelligent, timely and correct information. Giving the people the tools to protect themselves would save a lot of lives.” (Reid Wilson 4/9/20 NPR)
In 2005 thousands were stranded at the New Orleans Convention Center. They lacked information and the means to stay safe. I sat in front of the TV around the clock, shaken and furious. Not since then, until COVID have I confronted so dramatically that we are not all in this together. We must work to be.
Explaining COVID: Try This…Not This
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| Click Here to View Video |
Many thanks again to the participants some from as far away as Carla White and Susan Reid from Health Literacy New Zealand, who participated in my recent Soundbite Series: Covid and Health Literacy
One thing that came out of those exchanges of materials and ideas is that it would be productive to share and discuss some examples of revised messages/materials. Rewrites that are very focused on how to make the text more readable and usable by the general public.
As we discussed in the numeracy seminar, there is much research to show that adults (in the US and elsewhere) struggle with basic calculations and visual representations of numbers. And yet with COVID these precise things are everywhere: rates of spread, rates of death, percentages, and all types of data visualizations – charts, numerical graphs, logarithmic graphs, animated scattergrams, and GIS map.
So how about a literal title for these posts!
INSTEAD OF THIS…TRY THIS (suggested with all due respect to the folks who worked on the original messages)
Example 1: taken from the comprehensive and constantly updated
NYC “Daily Counts” segment on the NYC COVID-19:DATA https://www1.nyc.gov/site/doh/covid/covid-19-data.page
HINT Dear Reader…focus on the differences in the before and after introductions to the graph.
INSTEAD OF THIS – (original language on the site)
“Daily Counts
This chart shows the number of confirmed cases by diagnosis date, hospitalizations by admission date and deaths by date of death from COVID-19 on a daily basis since February 29. Due to delays in reporting, which can take as long as a week, recent data are incomplete.”
TRY THIS – rewrite
This chart shows you 3 different types of data: 1) Number of cases of COVID by date, 2) Number of hospitalizations by date, and 3) number of deaths every day since February 29. You can use your pointer to move over the dates.
——————–
Why THIS?
- Reading and comprehension are improved if you use a good intro – what linguists call a “superordinate pre-statement”. It tells the reader to “get ready to read about x.”
- The original intro (pre-statement) is one longer compound sentence and it’s easy for the reader to get confused about what counts are going to be displayed.
- numbering ( or creating some type of visual list of content) generally makes the text easier and quicker to read.
- And if a reader (me) skips over the intro and goes straight to the graph but gets lost, the rewritten intro is easier to refer back to.
How’m I doing?
Anyone have some other ideas?
Worth a look – how public handles COVID data charts
Some nice insights from researchers in London
LSE Covid 19
LSE Covid 19
https://blogs.lse.ac.uk/covid19
See also my April post on numeracy.
Simple Should Not Be Stupid: Exhibit #2 The Infographic
Continuing on here with the examples of the unintentional ways simplified, “easy to ready” health information doesn’t meet the challenge of educating and preparing the public to better understand and take actions in complex emergencies like COVID19.
EXHIBIT #2
The Infographic
We have grown used to seeing graphically dominant posters, or “infographics” promoting and reminding people of basic hygiene messages: washing hands, staying home when you’re sick, etc. Below are two examples. The first, from H1N1 (2010), the second, COVID 19.
(H1N1 Infographic)
These posters are excellent at what they set out to do – promote the basic hygiene message. The message represents the hallmark role of public health and messages like this have been used since the early 1900s.
Disseminated widely, they are interpreted easily, quickly and they have a long shelf life. Until Covid you were very likely to still see the “Clean Hands” posters from N1N1 .
The WHY? Of it All
What is often not given as much attention however, including messaging ( and design) is the “why” of each of these directions.
· Why should I throw the tissue away?
· Why shouldn’t I touch my face?
Nearly everyday we hear health experts and local government officials pleading and coaxing people to “practice social distancing”. Keeping our distance is proving to be thorny if not outright contentious. We’ve called on people’s desire to stay safe, protect their loved ones, practice more civic responsibility, and be “in this together.” Libertarian ideologies aside, I think there is still so much more to do to meaningfully teach (and repeat) what we know about transmission, the efficiency of this virus, and the perils of innocuous behaviors – the WHYS of social distancing.
Amidst this tragic pandemic many experts are already reimagining a post-pandemic world. The current approaches to simplifying complexity should be re-examined. Millions who struggle with health and science concepts and information, are left with a diet of “simplified” information and piecing together sound bites from mainstream media, social media and pseudoscience then reinforced by their peers, all picking over the same sub-standard information. A recipe for contributing to health disparities.
Think of David Maccauley’s The Way Things Work. A whole book of infographics!
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| Page from David Macaulay. The Way Things Work. Parsippany, NJ :International Playthings, Inc., 2004. |
Infographics allow us to combine various elements – text, image, chart, diagrams to present information and explain complex issues in a way that can quickly lead to insight and better understanding.
The “Galileo” of data graphics, Edward Tufte, has written and spoken eloquently and often about the fundamental importance of rendering visual information so that it conveys and teaches “forever tasks”.
“…I’ve been ever since preoccupied with how the fundamental tasks of thinking can be replicated in our designs of information, so that our architectures support learning about causality – that’s a forever cognitive task – support, that our architectures support making comparisons, which is a fundamental forever task. Our displays help us assess the credibility of a display, and how do they know that? That’s a forever task.”
So it’s true we are calling for the public to act responsibly and intelligently for their own safety and the safety of all of us. Can simple information really do that heavy lifting? I’m not seeing it.
The goal should be to adopt better communication methods from the excellent theory and practice from reading research, cognition and information processing, information design, usability and, intramedia effects. At the very least we cannot expect people to adopt and stick with hard to do things like staying home indefinitely, social distancing and wearing masks if they’re not somewhat in on the discussion with all of us together.
Covid: simple should not be stupid – Exhibit #1
Since the early 90s, in response to large scale national studies revealing the low health literacy of at least half of the population, public health experts have promoted a “prescription to end confusion”. Simple, “easy-to-read” “plain language” to yield improved health literacy, and thus improved health behaviors and better health outcomes.
For just as many decades (?! ) my professional work has involved reviewing lots of health information to determine readability and usability. Looking at these simplified texts I have seen a growing pattern of
- deleting out most of the connections that make sentences easier to read;
- deleting out basic science concepts and information.
Much of this overly simplified information has little ability to prepare or educate the public to better understand and take actions in the face of complex health and especially a complex emergency like COVID19.
One of the most common problems with much “simplified” health messages is the misconception that readers are best helped by short, disconnected sentences that read like the telephone book. Here’s what I mean.
4 steps are common in “simplifying” :
- · use simple vocabulary
- simple sentences
- use one line per sentence
- use a readability formula to check the reading level.
These sentences may be “simple” on the surface but the text – the group of sentences is not very comprehensible. The staccato of these five disconnected statements would strike any fluent reader as odd and unsatisfying. This type of writing runs counter to accepted reading and information processing theory and practice.
In this short text (cluster of sentences) there is just not enough information, stepping stones, to make good inferences. It’s like giving someone a puzzle and saying “Here you go. You figure it out.” Yet its format is ubiquitous, especially among those writing for low literacy and low health literacy audiences.
Reading involves making meaning across sentences and paragraphs. A well-written group of sentences helps the reader make those connections and make meaning. At minimum these five sentences could be reimagined as:
Vaccines protect us from many kinds of illnesses like measles, polio and the flu. But right now there is no vaccine for the virus called Coronavirus. (And) we can’t use antibiotics to fight Coronavirus because antibiotics do not kill viruses. Antibiotics kill bacteria. So doctors are working to develop (make) a vaccine but this could take a year or more.
SHOW ME THE SCIENCE!!!:public understanding of Covid
The antibody piece is critical, as you described, because at this time, we can’t – if we have – let’s say asymptomatic status is inversely – symptomatic status is inversely related to age, and so the younger you are, the more likely you are to be asymptomatic: We have to know that because we have to know how many people have actually become infected.Got it!
We need to do antibody testing, not only test people who are symptomatic, because some populations, like younger people, may have been exposed to the virus. Younger people often had the virus but didn’t but didn’t have symptoms. This would make them dangerous transmitters and that would really make it hard for us to contain the virus. (my “translation”)
I almost picked this topic and this remark at random. Most of what she and Dr. Anthony Fauci have spoken about over these weeks has required the lay person to listen carefully and translate.
Now, just think of some of the terms that have become part of your daily listening environment, if not your daily small talk over the last 3 months:
- novel virus
- emerging infectious disease
- chain of transmission
- modeling
- rate of infection
- flattening the curve
- social distancing
- high throughput vaccine development
- antibody testing immunity passports
Each word, not just a vocabulary word – but coded language signifying (pointing to) an important and complex science, health or behavioral concept.
Now just think about this fact.
Over 40 years of large-scale study data tells us that less than 1/3 of the US population is science literate. Ask adults in the US if antibiotics kill viruses or bacteria and about half will respond incorrectly. As for naming the steps in the scientific method, half are in the dark. And probe the purpose of a control group in a new drug’s development and you’re likely to get blank stares from half the population. Less than 25% understand what it means to study something using the scientific method. (Science & Engineering Indicators 2018)
What people attend to and the effects of any message on a person’s attitudes and behaviors is a thorny business – it involves a multitude of complex and interacting mediators – knowledge, cognition, culture, intramedia effects, etc. But at the very least we cannot expect people to adopt and stick with hard to do things like staying home indefinitely, social distancing and wearing masks if they’re not somewhat in on the discussion– in on the “why” of all this.
Just not going to happen.
The millions who are not very science savvy, for whom basic health concepts are shaky, need :
1. Better messages that go beyond basic hygiene and explain the “why” of things.
2. Better messaging about transmission and spread
3. Consistent well-modeled behavior that builds trust.
4. And lots of this…
Covid minus the Science = Fear and Outrage*
( a play here on Sandman’s Risk = Hazard + Outrage)