How to curb the next pandemic: public health literacy

In August 2020, the U.S. Department of Health and Human Services released Healthy People 2030 to improve health and well-being nationwide. This roadmap for public health efforts over the next 10 years includes a new definition of health literacy: The degree to which individuals and organizations “have the ability to find, understand, and use information and services to inform health-related decisions and actions.”

Missing from this definition is the concept of public health literacy, which includes decisions that benefit the community. Much has been said regarding the need to expand funding for public health, but if this is done without partnerships to improve public health literacy, the efforts are likely to fall flat.

Conspicuously absent is the need to reconstruct curriculum from kindergarten through 12th grade to build a foundation of public health literacy, to understand how individual choices affect the health of communities.

As the COVID pandemic has clearly illustrated, public health literacy is at least as important as reading, writing and STEM (science, technology, engineering and mathematics) to the well-being of our country.

Evidence suggests that insufficient adherence to public health recommendations — mask wearing, physical distancing and hygiene — by the American public during the pandemic contributed to the high toll taken here. These are low-tech mitigations practiced by many countries around the world. Limited adherence to public health recommendations in our country has been attributed to misinformation, political rhetoric, personal freedom and limited health literacy.

Now that we are entering a phase of the pandemic when science and technology are taking a lead role with treatments and vaccines, this country is showing our strength. However, our improved situation does not excuse our public health literacy shortcomings.

In a country for which personal freedom is a treasured value and a protected right, a high level of public health literacy is essential. When decisions to wear a mask in public and receive a vaccination are protected as personal freedom, there is an assumption that this choice is reliably informed. To make such decisions based strictly upon personal convenience or personal risk without considering the impact on the entire community is ill-informed.

Educating the public about such topics as quarantine, isolation, vaccination strategies, consumer manipulation and routine preventive care should be central to the curriculum in primary and secondary schools. Doing so would also address issues of equity by filling gaps in a health care system that is not universally accessible.

Numerous insights could buttress our communities against the spread of SARS-CoV-2. How many understand the difference between a virus and a bacterium, and what those differences mean to an outbreak response? What is the difference between contact, droplet and aerosol transmission?

How do the incubation period, infectious period and the presence or absence of symptoms affect transmission? These questions pertain not only to the COVID-19 virus, but also to long-term foes like chlamydia, HIV and influenza.

In 2019 the California Department of Education adopted a revised framework to guide K-12 health education in schools. Diligent efforts are required to maintain bridges between cross-cutting topics in science and health. A broad range of opportunities exist to further expand science-based insights into community health. Doing so can help students reason for themselves about health decisions that extend far beyond themselves.

Shortcomings in public health literacy leave us vulnerable to misguided beliefs. While humble skepticism is a welcome foundation for science, irrational skepticism about vaccine recommendations and climate change undermines our social responsibilities. An educational system that encourages critical thinking and rational debate on scientific matters is a most potent ally in our efforts to disarm the flood of misinformation confronting us in the digital age.

Expanding funding is critical to rebuilding a strong public health sector, but doing so successfully requires a new and stronger partnership between our public health and educational systems.