People should get vaccinated against contagious diseases for their own
safety AND because vaccination is a critical way to eliminate that disease from a population. These two facts are central to public health messaging.
The first message is sort of simple “Get
Vaccinated." (Not saying that people’s
responses to calls to vaccinate are not fraught.)
Today I’m focusing on the
second function of the vaccination message- to foster the public’s understanding
of disease elimination. Uncannily, health writers, especially when they're writing definitions, seem to
fall into a haze of complex and circular Epi concepts and language, not shared by
the general public.
The Fog of Words
Example
(accessed 1/30/15)
Q: What does "measles
elimination" mean?
A: Measles elimination is defined as the absence of continuous disease
transmission for 12 months or more in a specific geographic area. In such
areas, there may still be measles cases, but they are from infected people who
bring the disease into the area.
A Health Literacy Load
Analysis – (what the message assumes the reader knows)
· “continuous disease
transmission” – both read it and understand it.
above has a critical
timeframe ( 12 months).
Q Public
So
let’s just say I’m one of the millions in the US (actually at least 50 % of
adults) who reads at 8th grade level or lower and who doesn’t have a solid foundation in health concepts. I
stumble across “the absence of continuous
disease transmission”.
(To further fog
things up, the link the reader sees takes you to
A JAMA
Pediatrics article with a reading level
and science literacy level of post HS/college)
http://archpedi.jamanetwork.com/article.aspx?articleid=1787786
Here’s
what I likely come up with trying to read and understand this definition.
- · A person is “absent” from
the area where the disease is.
- · Or I skip over the one word
I know, “absence” and start with “continue”.
So something about continuing the disease. Maybe people can continue to get measles for
12 months.
This
definition bypasses the easier to read active verb form. Instead, it turns the verb into a noun-deactivates it (nominalizes it) รจ”the transmission of measles.”
We
know that active forms of verbs and sentences are generally easier to read.
If
we unpack the complex sentence above we get 3 active ones:
The
disease is transmitted.
The
disease is transmitted continuously.
The
disease transmission must stop for 12 months.
You
could write the definition like this:
Q: What does "measles
elimination" mean?
A: Measles elimination is when people living in
the same geographic area stop spreading (transmitting) the disease from one person to another for at least 12 months. There is not more measles in the area.
Measles may start again if an infected person brings the disease into the
area.
Any other ideas?