Communication in global health

This will be a little rambling...

This weeks readings (and, most the of course readings) have me thinking about the specific role to be played by the Communication discipline in public health. To me, it seems like the traditional transmission or "magic bullet" model of health interventions is in the rear view of global health. By magic bullet, I mean that we design a health campaign aimed at changing an 1) attitude, 2) behavior, 3) value (yikes, loaded). You do your formative research, go to your audience, ask all the right questions and design an intervention in such a way that the information or message is persuasive to your population of interest. This is simplified, but I think it reflects much of the past campaign work in developing countries or global health. I loved reading Paul Farmer’s work from this week, but, again, I want to find a place for Communication people. Is it education? Engagement? Communication for me is a tool—it is the means through which I hope to change or improve public health. With global health, we see that structural violence /barriers are the pressing issues—economics, poverty, gender relations and historic negligence by the government or ruling party. This is not so much an information war/campaign as development and infrastructure. I specifically loved that Partners in Health (PIH) were able to reject the notion that lay or culturally rooted beliefs about sickness or illness are what were stopping people from getting  or seeking care. It was a surprise to me. So what can Communication scholars add to the field of global health?
            As Communication scholars, I don’t think we can completely abandon the idea of the transmission model of communication. Our strength is in our understanding of the relationship between source, message, and receiver. This model is implicit in all of the work we read about—why are Community Health Workers (CHW) so effective? In my opinion, it is source characteristics and their effect on the reception of the message. This is an area where Communication scholars should excel! A second area I think communication scholars can contribute is in the area of health literacy and risk communication. Health literacy (more on this in later posts) is:

Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions (Hewitt & Hernandez, 2014).

The authors go on to say that “Nearly half of all American adults—90 million people—have inadequate health literacy to navigate the health care system”. Does that surprise you? This is in America, where I bet all of you would say or assume we are better educated than any of the populations in any of the case studies. That isn’t necessarily a criticism of any of us, but I think it does point to some implicit assumptions we have about the populations and areas in the case study (a rant for another day?). Risk communication, a slippery idea with multiple definitions, can loosely be defined as “any purposeful exchange of information about health or environmental risks between interested parties” (Covello, von Winterfeldt and Slovic, 1986; as quoted in Renn and Levine, 1991). The communication of risk is importantly tied to health literacy. Risk is an “especially complex mathematical concept that the public as well as many professionals need help in understanding” (Hewitt and Hernandez, 2014). While numerous disciplines are interest in the concept of risk and risk information, it should be the role of Communication scholars to study and aid the understanding and communication of risk once identified. 

Additional reading;

This links to a huge pdf on health literacy. 

http://www.nap.edu/catalog.php?record_id=18756&utm_medium=etmail&utm_source=The%20National%20Academies%20Press&utm_campaign=NAP+mail+new+2014.09.16&utm_content=&utm_term=&utm_expid=4418042-5.krRTDpXJQISoXLpdo-1Ynw.0