Health Literacy

What is health and what does it mean to be in good health? These questions and more have beset humanity prior to classical antiquity, as we continually struggle to combat disease and chronic ailments.

There are perhaps too many books and articles about health and wellbeing. Or are there?

One’s life could be spent dedicated to the singular task of reading every article and book published related to the topic, and one would only be at the outer margins of the field. Unfortunately, one must read quite a lot about to learn what constitutes good health and wellbeing. And that will always entail the capacity to discriminate between accurate, evidence-based information and unsubstantiated, false claims. Basically, one must be able to sift through the shit to arrive at the truth (or as close to the truth as possible).

I’m not going to tackle the first two questions I opened with. Instead, I want to address what it means to be health literate. As we approach the dawn of 2017, it behooves us to reflect on this as we prepare to craft our New Year’s resolutions.

As I have said: science makes the world go round.

Having health literacy or being health literate is akin to being scientifically literate. It doesn’t require an aptitude for learning anatomical structures, memorizing metabolic processes, or understanding every aspect of our healthcare system. It’s more about having a curious mind, one willing to approach health claims with a generous portion of skepticism. Let’s not be in any doubt that a formal education is helpful. Schooling certainly ensures one is familiar with the terms and concepts, but for the layperson, we must be able to provide the resources one needs to find answers which lead to healthful lives.

Health literacy arms one with a bullshit detection apparatus, allowing us to scrupulously assess health claims. The mainstream media often publishes articles polluted with confusing jargon, inflated claims, exaggerated crises, and alarming statistics. One must be aware of the language intended to deceive or mislead them. Language, especially in regard to health, is often grossly abused to sell overpriced foods and supplements. We are relentlessly assaulted by “miracle cures” and “superfoods” that will “reverse” the signs of aging and “cure” diseases.

Advertisers and marketing teams are well versed in the art of doublespeak. Need I remind the reader that “war is peace, freedom is slavery, ignorance is strength,” and health is death.

To illustrate this, one has only to look how sodium chloride is marketed. The opprobrium that was once reserved for fat and cholesterol has now shifted to salt. Restaurant menus and food retailers of all kinds inform citizens that salt is the enemy. Health professions have championed low-sodium diets as previous research has implicated excess sodium consumption with an increased risk for cardiovascular disease. So advertisers came up with innovative ways to sell healthy salts from exotic locations—some in a variety of colors—that tout health benefits the humble ionic compound could not possibly bestow; consumption of these salts were purported to have a minimal effect on blood pressure and, therefore, cardiovascular disease risk. Still further, potassium chloride was sold as a healthier alternative to its sodium counterpart.

Allow us to consider new research that suggests low-sodium diets may not reduce one’s risk for cardiovascular disease. The Lancet published a meta-analysis examining how salt intake affected individual outcomes for people with and without hypertension. The researchers found the following:

“Compared with moderate sodium intake, high sodium intake is associated with an increased risk of cardiovascular events and death in hypertensive populations (no association in normotensive population), while the association of low sodium intake with increased risk of cardiovascular events and death is observed in those with or without hypertension. These data suggest that lowering sodium intake is best targeted at populations with hypertension who consume high sodium diets.”

In short, high sodium consumption is only a concern for people with hypertension, while low sodium consumption is dangerous for everyone! Despite this research—which has perturbed a few people—the Food and Drug Administration, the World Health Organization, and the American Heart Association recommend consuming less than 2.3, 2.0, and 1.5 grams per day, respectively.

We shall see how advertisers and health professions reconcile their claims with new evidence.

I still advocate for and support strong teachers that instill a love of science in their students and who help cultivate curious minds. We still require effective communicators to navigate the catacombs of specialized research and the cobwebs of jargon. Health literacy permits us to engage in public debates about what good health is and how to achieve it. We can address (and combat) the invidious remarks of health professions that compare Ebola to HIV/AIDS.

That means that health (and scientific) literacy are just two means of achieving the best life possible. Perhaps that is part of the answer to my opening questions.