By Peter Boyes
One of our defining characteristics as a species is the nature of our communications with each other. How effectively we communicate is central to our societies. It’s at the core of how we learn, work and play. But there is one arena in which the quality of communication is vital and that is healthcare.
When it comes to communications about healthcare we’re talking about situations where people feel particularly vulnerable and afraid. Good communication is essential to deliver safe, effective, informed care but it’s a field in which advances in information technology and the internet are making it harder paradoxically to do it well surrounded as we are by a host of competing authorities.
It’s tempting to blame the scientists for doing a such poor job of communicating science to the public and countering the myths about healthcare. I’ve met a lot of scientists and medical experts in my career and generally communications is not their key strength. But by and large the public doesn't learn about science from scientists or medicine from doctors. Scientific, and this includes healthcare information, is mostly transmitted by word of mouth and a host of other non-experts competing authorities including celebrities, teachers, journalists, the authors of pot boilers and, yes, PR people.
There is no doubt we do need to do healthcare communications better. There is a lot of ‘stuff’ out there. Our audiences are becoming less able to understand information about healthcare at a time when we are awash in raw data from an explosion of media through online access.
In the most technologically advanced western society literacy in science is falling. You might assume that a country that can journey into outer space at will and dominates inner space through Silicone Valley would be at the forefront of scientific understanding. However, the USA has now slipped to 24th among developed nations on the OECD 2012 Program for International Student Assessment (PISA), which ranks the science literacy of 15-year olds.
This at a time when the proliferation of anti-science conspiracy theories is affecting the health and lives of millions. One example is the anti-vaccination movement, an irrational trend of mistrust of vaccines, or their ingredients. Its followers pick and choose bits and pieces of ‘evidence’ to claim vaccination causes a range of illnesses, which current scientific research has not yet fully determined.
People have forgotten that vaccine-preventable diseases have ravaged humanity throughout history. Only in very recent times have vaccines changed this significantly. Most Western societies barely remember the time when diseases such as mumps, measles, smallpox and polio were everyday and often deadly. Yet we are on the verge of allowing some of these diseases to reemerge by failing to communicate the benefits effectively. The UK and New Zealand both rank much higher on the PISA list for science literacy (12th and 6th) and yet both have also seen recent measles outbreaks linked to falling vaccination levels caused by ill-informed anti-science debate.
Vaccination levels have fallen in New Zealand, the UK and the US following this often one-sided publicity about vaccine safety and possible side-effects. Among these discredited allegations is one that vaccines cause illnesses such as autism. In spite of the science countering this some alternative healthcare practitioners and prominent celebrities have continued to speak out about the supposed danger of vaccines. Measles can kill children yet people are still given media time to claim that vaccination is more of a danger.
We don’t need to look very far back to see how anti-science positions and a failure to communicate health messages effectively can lead to death and suffering for millions of people. For years many jursidictions refused to accept the scientific evidence that the human immunodeficiency virus (HIV) causes AIDS and so did not provide pharmaceutical treatment to infected people.
Some estimates put the death toll cause by HIV denial at 300,000 people in South Africa alone, with hundreds of thousands more elsewhere. And that damage continues. Disinformation and poor communication about HIV and AIDS continues in many parts of the world with enduring resistance to reducing the spread by advocating for the use of condoms.
Much marketing communications of branded health care products or related benefits promotes its own agenda by undermining the basic scientific method so that our publics no longer understand that systematic logical investigation (science) is the best system we have for gaining knowledge.
Instead the makers of collagen capsules for a wrinkle free face, or powdered deer velvet purveyors for the relief of rheumatic pain, or mineral water packagers and brands promising cures for baldness, better milk, honey, or fat free alternatives, highjack or distort science to suit their own stories.
It leaves us with a public ready to believe all sorts of nonsense. Not just that a snazzy package will make the contents better for you. According to a much quoted 2005 Gallup poll about a quarter of the people surveyed in the USA, Canada and the UK believed that astrology has a real effect on their lives and communication with the dead was an actuality.People forget facts and need reminding regularly not just about measles and vaccination and HIV and condoms but about the importance and relevance of science itself so that they can come to an informed understanding of their health care needs. But in order for them to do that people need to be able to think about the evidence scientifically so they don’t have to make a choice between faiths in competing authorities.