by Anna J. Allen

In honor of the Darkest Day of the Year, I’m writing about a dark moment in health literacy — one that shows how pervasive low health literacy is even amongst the best educated, and most powerful, of us. The moment occurred during President Barack Obama’s recent rationalization for keeping the birth control product Plan B available only by prescription to people age 16 and younger.

At a news conference two weeks ago, the president supported the decision by U.S. Health and Human Services Secretary Kathleen Sebelius by saying: “The reason Kathleen made this decision is that she could not be confident that a 10-year-old or an 11-year-old going to a drugstore should be able — alongside bubble gum or batteries — be able to buy a medication that potentially, if not used properly, could have an adverse effect.”

Whatever your stance on Plan B, if you are pro-health literacy you cannot support this statement. All medications, whether they be over-the-counter, prescription, herbs, vitamins, or supplements, can have harmful effects even if they are used properly.  In fact, that is why local poison control centers are staffed with pharmacists. Second, children age 10 or 11 already can get their hands on copious amounts of medications  that potentially, if not used properly, could have an adverse effect.

Popular over -the-counter pain relievers widely available to 10 and 11-year olds have been linked to Reyes Syndrome, asthma, liver and kidney damage, and excessive bleeding among other issues. By singling out Plan B, the President appears as though he is unaware of the other dangers lurking in the aisles of most pharmacies.

The misleading science in the President’s statement garners him a low health literacy grade. We hope he does better in his next outing, and takes a leadership role in this tremendously important area of health.  Health literacy, according to the Journal of the American Medical Association, is a stronger predictor health status than age, race, employment status, or education level.

Improving health literacy should be one thing both sides of the aisle can agree on: It reduces costs and improves health. Mr. President, we respectfully request you lead by example!

By Helene Eisman Fisher

Here’s something to chew on:  Around 62 million Americans – about one in five of us – live in rural and frontier parts of the country.   There are fewer health care professionals in these areas.  If you live in or near a city, say New York City, L.A., Chicago, or Phoenix, etc. it’s easy to take our ability to get care for granted.  I am not talking about quality.  I mean being able to find a doctor, a dentist, a psychologist and so on, that you can get to and who can see you when you need it.  It’s also much harder to get to a high-level trauma center in under an hour in rural places, particularly if where you live is remote. Rural and frontier areas also tend to have higher poverty rates and older populations with many chronic conditions that require on-going care.

With all these challenges, it’s no wonder that the Health Resources and Services Division of the United States Department of Health and Human Services has designated certain places in our country as Health Professional Shortage Areas (HPSAs).  These are “Medically Underserved Areas/Populations… that have… too few primary care providers, high infant mortality, high poverty and/or high elderly population.” [http://hpsafind.hrsa.gov/]

It can be hard, to say the least, to be a patient or caregiver, when you live in a place that might require you to travel quite a distance for care.  Aside from the geographic challenges, you might not have health insurance or enough of it.  Many rural patients and caregivers pay out-of-pocket for care, sometimes more so than their urban counterparts.  And, if you are treated you may end up managing quite a lot on your own at home.

But there are good things too.

Rural and frontier health care professionals often treat whole families from the youngest to the oldest.  They tend to be the medical equivalent of one man bands:  They birth babies, diagnose and treat cancers, set bones, stitch wounds, make earaches go away, and help a great grandfather be more comfortable in his last days.  And yes, rural and frontier doctors sometimes make house (or ranch or farm or reservation) calls.  By necessity, they often spend a lot of time going over care plans and next steps and how-to’s with their patients and caregivers.  In other words, the care tends to be comprehensive, holistic and patient-centric.  And patients and caregivers can benefit greatly from that.

So let’s give a shout out — or a yodel — across the hills, valleys, lakes and prairies to all the rural and frontier doctors and nurses and medical staff out there  — and those who are helped by them.  In many ways, these are the people — professionals and non-professionals alike –  who are on the frontier of health literacy and patient empowerment.  Why? Because they have to be.

Happy National Rural Health Day.  You can learn more at http://celebratepowerofrural.org/.

Find a Better Name for “Health Literacy” and Win Big Bragging Rights!

By Anna J. Allen

Back in 2004, when Say Ah! was just a conversation at the kitchen table, co-founder Helene Eisman Fisher and myself would call our friends and colleagues to tell them about our plan to start a health literacy non-profit. We expected our announcement would receive a reservoir of  support, followed by much commiserating over how totally confusing health care has become.

Instead, we were often met with silence, and then the question we have come to dread: “What is health literacy, exactly?

After defining “health literacy” to everyone from oncologists to adolescents to policy makers, we’ve come to see it as not just a term but a test. Those who know what “health literacy” is seem to have it, at least to some degree, and those who don’t, well, don’t. For those most in need of health literacy, the term is often yet another jargon-y phrase that is at best difficult to grasp and at worst intimidating, exclusionary, and misleading.

In an effort to find a term that people of all abilities can understand, Say Ah! is honoring “Health Literacy Month” by holding a contest to re-name “Health Literacy.” Send us your new phrase, term, even your long-winded but clear explanation. We don’t care — give us something we can use! We’ll print them here, tweet them, and post them to Facebook. The best new name wins bragging rights, and our deep and everlasting admiration! Start sending us examples to info@justsayah.org. May the best definer win!