Are You (Health) Literate?

13 02 2013

plainenglishHow’s your health literacy? Literacy, in this instance, doesn’t only mean can you read and write—are you literate. It means can you read instructions on a bottle of medicine, can you listen to a healthcare professional tell you about your health problem and walk away fully understanding what she said, and can you then figure out how to get the care you need for that particular problem?

The IOM defines health literacy as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

Po-tay-to, po-tah-to.

By any definition, I suspect that most of us fall short of acing the health literacy quiz.

I went in to see my dermatologist last week. Every year I go to her office, she looks at my rosacea, and renews my prescriptions.

And every year I learn something new about my meds.

I’m not sure if she’s not offering all the information or if I’m not retaining it.

This year, I learned that I have to take Oracea® at the same time every day because it lasts 24 hours. If I take it at 6:00 p.m. one day and 7:00 a.m. the next day, that’s too often, and if I take it at 7:00 a.m. one day and 6:00 p.m. the next day, that’s not often enough.

I could swear that she did not tell me this basic piece of information at any time in the past. (I’ve been taking this pill for three years.) She could swear that I’m not paying attention and that she did tell me at some point.

I looked at the bottle when I got home and directions were to take one capsule by mouth one time daily (didn’t mention the same time of day thing).

I don’t know. It’s hard to say where the communication fell down. The point is, it did.

So what can we as patients do about our health literacy?

There’s a lot of info on the web for clinicians and others on how to communicate with those who have low health literacy. In other words, putting the onus of improvement on the provider.

That’s good. Many providers don’t talk the talk of the non-scientist. But what can we do to keep up our end of the relationship?

It’s harder than you’d think. Because we’re not medically trained, we don’t always know to ask certain questions. We rely on the provider to tell us what we need to know (and then some).

One provider I saw recently wanted to prescribe a medicine that I’ve not used before. What are the side effects, I wanted to know.

He snorted impatiently and pulled out his smartphone and showed me a list and said he didn’t have time to go through them all, but if I wanted to sit there and read them I could.

Hmmmm.

On the other side of that coin, I don’t write down everything a provider tells me about a new medicine. I trust to memory and the directions on the bottle. Not always the way to go, apparently.

Here’s a starting place, if you want to create a checklist for yourself: http://www.ahrq.gov/questions/ 

Share any other ideas you have in the comments. Maybe we can chip away at this wall from our side while the providers do the same on their side.

One day, the wall will be gone.

By Trish Parnell





Parents, Encourage Physical Activity!

8 03 2012

Spring and summer approach, and we begin to see the winter coats and boots come off and a new appreciation for summer activities blossom.

I am thankful to reside in the lovely “Aloha” state of Hawaii, where beautiful weather conditions grace us daily, although in any locality, it is difficult at times to keep our kids excited about their fitness and encouraged to stay healthy and active.

According to Duane Alexander, M.D., Director of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), “Lack of physical activity in childhood raises the risk for obesity and its attendant health problems later in life.”

As parents, we cringe at the thought of our children dealing with the long-term life health issues related to obesity, so what can we do to offer a healthy lifestyle? Lead by example.

The Weight Control Information Networks asserts, “Parents have an effect on children’s physical activity habits as well. You can set a good example by going for a walk or bike ride after dinner instead of watching TV. Playing ball or jumping rope with your children shows them that being active is fun.”

These activities can start at nearly any age. My daughter recently turned one year old. After work each day our favorite moments together are playing in the park. We practice “running” (as well as a toddler can), crawling up a steep hill, jumping, climbing, etc. Everything I do, she copies. It is a fun game for both of us!

The same can be done with elementary-age kids. I remember my dad teaching my sister and I how to play baseball. It was the biggest excitement of my day! He would play with us as a reward after we patiently waited for his personal workout to be complete. He encouraged us to play in the same general area as he was exercising to show that he felt physical fitness was important. Years later we competed in 5k races together laughing along the way. He showed me that exercise can be fun, and I enjoy it to this day.

Take the time to enjoy physical activity with your children; it will benefit their lives into adulthood and beyond!

Alexander, D. (2008, July 15). Children’s physical activity drops from age 9 to 15, NIH study indicates.
U.S. Department of Health and Human Services. (2010, April 07). How can I help my child be more active?  

By Melissa Parnell – Melissa will appear as an occasional guest blogger on this site. She is working on a graduate degree in Human Services with a concentration in health and wellness. She minored in health and wellness in college and is an AFAA (Aerobics and Fitness Association of America) certified personal trainer.

Image courtesy of Melissa Parnell





Donuts to Broccoli

18 08 2011

When my brothers and I were children (lo these many years ago), our mom went into the kitchen every night and cooked dinner for the family. We had beef, pork or chicken, potatoes, two kinds of colorful vegetables and, once a week or so, a homemade dessert.

Occasionally, noodles would take the place of the potatoes, but pasta never graced our table. We were Midwesterners, for crying out loud.

There was one obese kid in our school and we knew just a handful of obese adults. We didn’t know anyone who was undernourished, except as abstract beings brought into play when we didn’t want to eat black-eyed peas: “Don’t you know there are starving kids in (fill in the blank)? Eat your peas!”

It feels ridiculously self-indulgent to talk about obesity when families in Somalia and those escaping that land are starving, but there you are. Today I am thinking and acting locally.

Millions of obese Americans face health risks that could be eliminated or reduced by weight loss. Obesity impairs immune function and causes a host of other ailments. It’s time to step away from the donuts and embrace broccoli.

I used to cook a lot—experimenting in the kitchen was therapeutic. Then I became a parent. Between work and homework, the activities of two kids, and one incredibly annoying picky eater, I gradually found little time and less inclination to do anything in the kitchen besides microwave leftover take-out or “cook” a prepackaged dinner in the oven.

My weight has nearly doubled in the last 15 years and my kids are lethargic slugs.

When we were young, my brothers and I spent hours outside running and playing and were never tired. Long car trips were what exhausted us. Almost the opposite is true today—my kids can sit and text or surf the web or listen to their iPods for hours.

I physically feel the effects of obesity, and the guilt of not providing a healthier daily diet for my kids gnaws at me. Are any of you going through the same thing? Or maybe you were and you’ve found a way out? What did you do?

I bought some melon. And broccoli. And for once we’re going to eat them before they go bad, hiding in the back of the refrigerator.

Obesity is preventable. It’s time I got off my considerable rear end to do something about it for me and for my kids. And like it or not, they’re unplugging and getting off of the couch and out into the world.

If you have any suggestions, I’d love to hear them!

By Trish Parnell

Image courtesy of franςois @ edito.qc.ca





Ramadan – Healthy Fasting!

4 08 2011

Ramadan is a holy month for those who follow Islam. During this time, many are expected to fast from sunrise to sunset and by doing so, learn self-discipline, patience, and empathy for those less fortunate.

Years ago, I lived in a tiny country in North Africa where most of the citizens were practicing Muslims. At that time, Ramadan was in the summer, as it is this year. It was HOT. We’re talking Sahara hot.

I remember wandering around a small town one boiling afternoon, searching for an open shop—anyplace to buy water and maybe one of those buttery croissants with a thin stick of dark chocolate wrapped inside. I’d heard of Ramadan, but was in my 20s and not used to inconveniencing myself for religion.

There was one bakery open. I can only assume it was because there was a large group of individuals with various religious beliefs staying in town for a few weeks.

I got my water and croissant and continued my wanderings. While I was busily licking the delicious crumbs off of my fingers, I noticed that the few townspeople on the road were politely and pointedly looking away from me.

Boy, did I feel dumb. And crass. And ignorant. It’s OK to skip Ramadan observances if you’re not a Muslim, but it’s not OK to walk around gorging yourself when others are fasting. In my defense, pitiful as it is, I’d been there about a week and was clueless to the reality of Ramadan. My experience with religion up to that time was that of a child, watching as adults got dressed up for an hour of Bible talk each Sunday, and then spoke no more of it the rest of the week.

It’s another hot summer and Ramadan is here. I wonder what fasting each day for a month does to one’s health? The fasting isn’t meant to be a health benefit or punishment, it’s meant to be a holy act. But, the potential for side effects to one’s health is a common concern.

Ramadan requires fasting from sunrise to sunset, and then eating and drinking is allowed. The body is not as stressed as it would be if the fast lasted 24 hours a day for several days.

If you are sick, or traveling, or of a certain age, fasting is not a requirement. But, for those who are fasting, it is terribly hard to perform manual labor. The body loses sodium and potassium through sweat, so working shorter hours and consuming a balanced diet in the evening and early morning hours is critical to maintaining good health.

Foods to avoid when breaking the fast are the same as at any other time—deep-fried foods, sugary and fatty foods. Caffeine is a diuretic. The last thing you want during Ramadan is consuming anything that increases urination (water loss).

Foods that are good for you when breaking the fast are also the same as at any other time—whole grains, fruits, vegetables, some protein and dairy.

The Ramadan Health Guide discusses possible health problems related to fasting, as well as solutions:

  • Thinking of food can increase the acid in one’s stomach, creating heartburn. The guide suggests continuing any heartburn medication you’re on and avoiding foods that increase stomach acid. Sleeping with your head higher than the rest of your body may help.
  • Those who are ill shouldn’t be fasting, so check with your doctor if you’re living with diabetes or any condition or infection.  You may or may not be able to fast, but if you do, there will be precautions you’ll want to take to do so safely.
  • Seems like everyone gets headaches when they’re hungry.  Take painkillers with your morning meal (check with your HCP first), wear a hat in the sun, get lots of sleep and know that, no  matter what, you’re going to hurt if you’re a caffeine lover and you’ve given it up for Ramadan.
  • Dehydration is an obvious problem. Stay hydrated when not fasting, and take in plenty of sugar and salt.
  • Some people gain weight during Ramadan. They consume too many calories when not fasting, to make up for the loss during the day. Everything in moderation!
  • Constipation can be a side effect of daily fasting. Keep hydrated and eat lots of fruits and veggies when you break your fast. If all else fails, there are over-the-counter options.

If you’re fasting for Ramadan or for any other reason, the guide is worth reading. There’s also a section for healthcare professionals that will be useful if your patients are observing Ramadan.

And finally, happy Eid-ul-Fitr on 31 August, the end of Ramadan!

By Trish Parnell 

Image courtesy of Vit Hassan





June: It’s a Guy’s Month

16 06 2011

Hey, men! It’s your week AND your month.

June is Men’s Health Month , and June 13 through 19 is Men’s Health Week.

What’s the point? Preventive medicine. Take care of yourself before you become unhealthy. Or, if you’ve already started down the path to poor health, do what you can to reverse that process.

The organizers of the Men’s Health Month and Men’s Health Week have tagged it with the line, “Awareness. Prevention. Education. Family.” Every single one of those terms applies to you, men. Here’s why:

  • Take the top 10 causes of death. Men die at higher rates from these causes than women. The top causes of death are heart disease, cancer, injuries, stroke, HIV/AIDS, and suicide. For every 162 women who die of heart disease, 249 men die of it. For every 2 or 3 women who commit suicide, about 10 men take their own lives. In keeping with that statistic, depression in men often goes undiagnosed.
  • In 1920, men and women lived about the same life spans. Now, women outlive men by an average of six years.
  • Men don’t go to doctors enough for well checks. Women are 100% more likely to go in for annual exams and preventive services than men.

How aware are you of what you need to do for preventive healthcare, not only for your own health but out of consideration for your family? Below is a short list to consider. For more information, find the complete list and other information at the Agency for Healthcare Research and Quality.

  • Age 18 and onward: Regular screenings throughout adulthood for depression, blood pressure, and diabetes (if blood pressure is high). High blood pressure is a silent, serious, and chronic problem that can cause stroke, heart attack, and kidney and heart failure.
  • Age 35 or older: Get screened for cholesterol levels. Do it even earlier, at age 20 and older, if you smoke or dip tobacco, are obese, have diabetes or high blood pressure, have a personal history of heart or arterial disease, or a family history of early heart attacks.
  • Age 50: Get colorectal cancer screening. It’s so easy. If you have a family history of colorectal cancer, your screening may need to be earlier than age 50. For example, I had my screening at age 38, partly because of symptoms. Because my doctor found and removed a large precancerous polyp, my first-degree relatives should all have their screening much earlier than age 50. My doctor told me that if I hadn’t had the colonoscopy done, I’d’ve been dead in five years. In other words, I wouldn’t have been alive to write this. Don’t be stupid. Get the screening.
  • Age 65-75: If you’ve ever been a smoker, look into getting screened for abdominal aortic aneurysm. The aorta is the largest artery in your body, and an aneurysm is a bulge in this artery. If it bursts, bleeding and death are a frequent outcome.

Think you can’t afford to take care of yourself? Use this search tool to find affordable or even free preventive healthcare in your area. June may be Men’s Health Awareness month, but you should be practicing awareness and prevention and educating yourself every day of your life, not only for you but also for your family. They need you around, healthy and alive, as long as possible.

By: Emily Willingham





Going Mobile

5 05 2011

We’re going mobile with our health info.  We’ll keep the websites and social media accounts we currently have, but once we find the funding (a daily mutterance in nonprofit offices worldwide), we’ll add access and tools for mobile users.

Researchers at the Pew Internet & American Life Project and the California Healthcare Foundation  studied mobile technology and found that 85% of American adults use a cell phone, with 17% of them having used their phones to look up health/medical info.  That figure goes up to 29% when we’re talking specifically about younger adults ages 18-29.

We want to stay connected to our audiences and make it easy for people to retrieve the information they need when they need it.  We believe that, just as the use of social media is embedded in the habits of Americans under the age of 30, so will be the use of mobile technology within a few years.  That’s where Americans are headed.  That’s where the world is headed.

A paragraph in the Mobile Health 2010 report reminds us of how social media usage was once talked about, as whispers of a changing reality, and now that reality is here.

“The ‘mobile difference,’ which Pew Internet first identified in 2009, is the observation that once someone has a wireless device, that person is more likely to use the internet to gather information, share information and create new content. These patterns are beginning to emerge in Americans’ pursuit of health information on mobile devices as well as traditional wired computers.”

These patterns will soon be the norm.  Where do you see your public health education dollars being spent over the next five years?

Photo credit: juhansonin





Vaccine Education Center

28 04 2011

Dr. Paul Offit, Director, VEC

The science of vaccines can be . . . daunting. The lists of ingredients and potential side effects make us want to second guess ourselves and our children’s providers. We need to be sure we’re making safe choices.

And the complicated schedules! They’re enough to make sane people pound their heads.

The folks at the Vaccine Education Center (VEC) at Children’s Hospital of Philadelphia have a gift for presenting the complexities of vaccines and attending issues in a way that’s easy to understand yet comprehensive in scope.

The VEC website has a special section for parents and adults of all ages.  While there, you can sign up for the Parents PACK newsletter to get monthly immunization updates.  In the March issue, there’s a timely post on measles and the dangers of rubella parties.

You’ll also find age-specific information on vaccines and the diseases they prevent. There are FAQs, but if you can’t find your question, you can send it in via a form provided on the site.

The VEC has created a library of educational materials on specific vaccines and commonly asked questions. These resources range from information sheets to more consumer-friendly bookmarks and brochures.

They also maintain essential tools, including vaccine schedules, facts about vaccine preventable diseases, and the latest in vaccine science.

To keep information fresh, the VEC pens a monthly “Ask the VEC” on a myriad of topics.

Starting in 2011, the VEC will present three or four webinars a year addressing evolving issues, recent ACIP meetings, new science and media reports.

There are layers and layers of information available on the website, for those of us who feel more is better.  And what parent doesn’t?

The VEC staff constantly works at sifting vaccine fact from fiction and explaining the difference in ways we can all understand.  If you have questions, they’re worth checking out.