Talking About Health; Why Health Communication Matters

Can you set the table please?

March 30, 2011 GUEST BLOG POST by Melissa VanAlstyne

“I have work to catch up on”, “I’m not hungry”, “I’m going out”, we have all heard these excuses when it comes to sitting down to a family meal and often it seems easier to just forgo it all together. However, research is proving just how big of an impact family meals do have. Not only is sitting down to a family meal a good way to keep the family connected but it also has a number of health benefits as well, one of which is promoting healthy eating habits among adolescents.

According to a journal article in the Journal of Adolescent Health [full citation below] having a family meal can help to detect early signs of disordered eating as well as help prevent disordered eating from ever beginning. Having a family meal allows adolescents to see their parents engaging in healthy eating habits and therefore model their own eating habits after them. In addition, eating together allows parents to monitor their children’s diet which allows them to detect signs of disordered eating earlier.

While simply prioritizing sitting and eating together is good in and of itself, family meals should be times that parents and children value and find enjoyable. This means keeping discussion at the meal free from conflict around food or other issues, thus making the meal something the family looks forward to each day.

While life is undoubtedly extremely stressful and busy and finding time to sit down and eat together may seem a daunting task, the benefits of making sure to prioritize this family time cannot be overstressed. Adolescents who report more frequent and enjoyable family meals have been repeatedly found to be at a decreased risk for engaging in unhealthy weight control behaviors. So find a time that works for your family, sit down, pass the chicken and enjoy!

Fulkerson, J. Neumark-Sztainer,D. Story, M. Wall, M.(2004).Are Family Meal Patterns Associated with Disordered Eating Behaviors Among Adolescents? Journal of Adolescent Health,35. 350-359

Why is belly fat bad for your health?

March 17, 2011

I guess we would have to be living under a rock not to have heard health messages about belly fat. What I remember hearing the most is something like, “Belly fat is bad for you.” or “You want to concentrate on that belly fat.” And what I really got out of the messages had to do more with how we look–that belly fat is not attractive–than how it relates to health. I had seen a number of programs addressing how to get rid of belly fat [ http://www.meandjorge.com/] but never really made a connection with why in terms of health. Until the other day…

I can’t even say what program was on as I was making a meal but I heard them say that belly fat is especially harmful for our health because it is fat that works it way between and around our organs. That it literally does harm by wrapping our kidneys, liver, and intestines in fat… that was a rather horrifying image. The program went on to say that one cannot have belly fat liposuctioned away…because it is wrapping and twisting its way through our insides. The fat that can be liposuctioned away is just beneath the skin… [see this for a discussion, http://blog.healia.com/00488/belly-fat-damages-blood-vessels-could-cause-cardiovascular-problems]

To me, this is an example of one of those messages that needs to be clearer. I especially think that men are being shown as at risk for having belly fat…but the emphasis is too often placed on how the men look and not on what is really happening inside their bodies when the pounds add up around their middles…

Or will it be Pennsylvania trout that will be the canary in the mine for Marcellus shale?

February 22, 2011

There appears to be no shortage of articles about concerns relating to the environment and Marcellus shale drilling in Pennsylvania[e.g., http://blogs.wvgazette.com/watchdog/2011/02/16/is-the-marcellus-boom-a-good-idea/]. Fewer concrete examples exist of action in this area. One exception is the organization, Trout Unlimited. The organization is partnering with the State, where loss of funding and the economy has contributed to challenges in efforts to collect data regarding water quality in the State’s streams [http://www.tu.org/conservation/eastern-conservation/marcellus-shale-project].

Volunteers will be trained to collect water samples. That is an important first step. It is less clear what happens next. Where will the samples be evaluated? How will data be stored? It is important to plan for consistency and to identify now any problems related to evaluating the water samples. If we fail to plan now, then the findings will be suspect later. So certification of the folks collecting the water samples is important. But we don’t want their hard work and training to be lost in warehouses where samples stockpile with no one to evaluate and track them. We also don’t want results to be discounted because the assessment of samples isn’t consistent or valid…

How does bad news about our health affect us?

January 28, 2011

One of the blogs I follow is Belinda Brasley’s, ‘Losing vision, Gaining insight…’ http://losingvisiongaininginsight.wordpress.com/2011/01/27/to-blog-or-not-to-blog/ Her journey with low vision is so parallel with my own that it is at times uncanny…. She puts into words my own experiences, including how she feels about low mobility training, using a cane, and other aids to adapt to losing one’s eyesight. Today, her post addresses how she felt at the news of having lost even more vision after being stable for some period of time. It made me think about how any kind of bad news about our health can drain us emotionally and physically.

In part, we go through a number of stages when dealing with bad news about our health. It takes some time to understand and it can make us angry. We need to grieve about what we have lost. We need to understand what it means for all the other parts of our lives, including relationships and plans we had for the future–work and play. Gilotti, Thompson, and McNeilus wrote about how bad news delivery is perceived in a 2002 article in Social Science and Medicine http://www.ncbi.nlm.nih.gov/pubmed/11999499. In short, it is not a good time for small talk. And it is probably not the best time to go into a lot of information about the situation. As I said, it takes some time… Being ready for all of that information will be an important part of managing the bad news.

What’s in a headache?

January 26, 2011

Perhaps a lifetime of health problems. Perhaps early dementia. If the headache is related to a sports concussion…

When I was a child, we didn’t wear helmets to ride our bikes. My kids didn’t wear helmets to ride bikes or to skateboard. We were lucky. They were lucky. Really.

I remember falling off my bike. Plenty of times. We raced and crashed and burned. Perhaps the scariest crash riding a bike without a helmet happened when my daughter way old enough to sit up in the child carrier on the back of my bike, I was riding with her on a bike trail, and some crazy person pushed us off the trail and we–crashed. I was able to keep her upright by sheer will as we went flying and I lunged around backwards to grab the bike that I was no longer sitting on. The deep bruise on that leg and knee that went down is still memorable…it lasted for months.

It’s important that we are talking about athletics and concussions. http://www.heraldextra.com/news/opinion/editorial/around-the-nation/article_a952962f-591c-53c2-9ad6-64bf42b5ebfc.html It is important that parents wear helmets when they ride bikes and get helmets for their kids. And if there is an accident, get a new helmet…it is designed for a one time use. And let’s keep talking about it, so that we are less to have concussions that go unreported and untreated…

Have you been following the news about liver damage and acetaminophen?

January 14, 2011

We don’t set out to overdose on our over the counter drugs, but some of them are ‘invisible’… they are included in so many products that it can add up before we know it and cause problems. Serious problems for acetaminophen… 42 thousand hospitalizations for overdosing… 400 deaths… just in the U.S. http://www.nytimes.com/2009/07/07/health/07well.html?_r=1

But the answer is not switching… aspirin is invivisible in lots of products as well. I write about this in the chapter about health profits in Talking about health… Elderly adults using creams with aspirin and young adult athletes seeking pain relief have had problems with overdosing by accident because the ingreident is included in so many products… A note of caution for us all…

If you are driving or traveling during the holidays, do you know you are at risk to form blood clots?

December 20, 2010

119_1944a3 Tens of thousands of us develop blood clots each year. Sometimes, they start as a pain in your thigh. Often, the cause is too little movement for too long a period of time. Hence, the need to take breaks and walk around if you are traveling in a car. Get up and move about on the plane or train or bus. Stretch your toes forward from your ankles when you are sitting and then pull your toes back. Repeat half a dozen times.

Stay hydrated. Drink water and not alcohol. For more advice about traveling and blood clots, visit http://www.mdtravelhealth.com/illness/deep_vein_thrombosis.html.

AND, talk to your family about this. Ask, “has anyone had a blood clot?” Your family history may predict greater than average risk. All of us need to avoid cramped spaces and long periods of not moving around. Some of us may have a family history that suggests we should be tested for genetic contributors to clotting. You won’t know if you don’t…ask.

Have you gotten your flu shot?

December 6, 2010

A couple of weeks before setting out on the Thanksgiving trip to hike in the New River Gorge area and dine with family at a bistro in Asheville, North Carolina, John and I got our flu shots. This year, the shot combines the swine flu shot with the ‘regular’ flu shot so that you will not be offered two…but instead get two for the price of one. I hadn’t paid much attention to this fact until arriving for the appointment to get the shot.

I have adopted the view that getting a flu shot is something I should do, even though I find that end up with a bruised arm that I can’t sleep on for a couple of days. I do it because I teach a lot of college students who come and go from their hometowns across the northeast and beyond, and they work in area establishments with many customers. So, protecting me and protecting them…the public good angle of public health discussed in the book.

How does informed content about the flu vaccine work for you when you get the flu shot? For me, it went like this. Here is a form for your to read whenever you have time and want to. Are you allergic to eggs?

Vaccine information sheets are not quite the same as informed consent documents for surgery. We don’t have to sign a vaccine information sheet. Why? I suppose because so often, shots are being given to lots of people in a small span of time.

Perhaps because shots are given by so many different types of health care staff and a wide range of questions might be asked, making it hard to provide training for responses. And, shots are supposed to benefit the public in general. So, identifying the possible risk of receiving a shot–such as being allergic to eggs and the flu vaccine–becomes a shorthand method of informed consent.

Recently, there has been some effort to encourage those with egg allergies to talk with their doctors about the flu vaccine. An article on Science Daily discusses the issues [http://www.sciencedaily.com/releases/2010/10/101018121440.htm]. Take a look…

Why does Vicks vaporub say for ‘external use only’ on the warning label?

November 22, 2010

I took my plastic bag and whipped through my medicine cabinet, laundry room, and kitchen over the counter medication shelf. We were discussing warning labels in my undergraduate health communication class, and I use products from my home to have students identify the parts of the warning as we discuss the content and what the research says about the likely effects.

Several products say, ‘for external use only.’ One says to avoid use on the lips. The latter is a product called ‘bite-aid’ and it comes in a chapstick kind of container. I told the story about sitting in the airport and reaching into my purse for my chapterstick, feeling the ‘bite-aid’, and applying it to my lips. It didn’t take long to feel like my lips were swelling. I told my class about how I asked my husband if my lips were swelling. I told him how odd they were feeling after putting on my chapstick, which I held out to show him. Still not realizing that I was not holding out my chapstick. He took one look and said, ‘That’s not your chapstick.’ With surprise, I looked down, read the label, visited the bathroom and scrubbed my lips–which soon returned to feeling normal.

“That,” I told my class, “is an example of a potential harm related to a product that could be solved with different packaging.” As I noted, “I didn’t intentionally put it on my lips, so even though the label says, ‘do not use on lips’, that content didn’t really help in my situation.”

One of the student’s then told about how the Vicks vaporub said, ‘for external use only.’ “My grandmother always made us eat a tablespoon of it when we were sick,” she said. I hardly knew what to say to that. “Why?” I asked. “Because it is for your chest cold and that is how to get it in your chest.” I was quiet as I thought about that. “It works,” she said.

Another product a student had was benadryl gel. The label also said, ‘for external use only’. The student observed, “That’s probably because you usually take benadryl as a pill… and this liquid looks like you could put it in a spoon like cough syrup. So I bet some people have done that.”

Warning labels have content that may help us avoid harm…if we read them. …and they make sense.

What does health policy have to do with communicating about health?

joy-in-boat-hoc-2009 November 16, 2010

Product recalls. Nutrition labels. Informed consent documents. Patient package inserts. Lots of people spend a lot of time designing these messages. Yet, research shows that far too often, no one reads them. Of course, one reason we don’t read them is because the print is so small, we need a magnifying glass to see what it says. Other times, we take for granted that the product wouldn’t be available if it was going to be harmful. Still other times, we need to add up the content of product labels to know how much we are really getting. Too much of an ingredient, such as aspirin, can cause serious health problems and may occur because aspirin is included in creams being used for joint pain or products being used to treat cold symptoms or any number of other combinations of things being used that individually do not pose a risk but combined can even be deadly.

parrottch5fig2 Warning labels provide another way that policmakers are trying to assure that we have information to protect our health. Warning labels are designed to get our attention with a signal work about a hazard: caution, danger, or often–warning. The label also includes a statement about what makes the product risky. For example, if it contains alcohol, then it may be flammable. If it contains an herb, it may interact with prescribed medication or the drug to be used for your medical procedure. The label may also include a way to avoid the harm, such as talking with your doctor about using the product. And it may include content about outcomes that could occur, although these may be worded abstractly, such as–“adverse reaction”–meaning what exactly?

In the end, it is still up to us. Policies give us the chance to gain some information. They can’t make us read the labels and use them to make decisions…