Chopsticks To Chopin
Starting at the top is not easy

Improving the Health Literacy (HL) of all Americans is an essential project finally getting the attention it deserves.  Then Surgeon General Dr. Richard Carmona made a plea for HL during a trip to Arizona three years ago, and numerous others on the national stage have echoed his sentiment. A comment is often made that we “can’t be better users of the system until we all have more knowledge of it.” This immediately begs the questions, “Where do we start, what should we teach, at whom should we direct our efforts, and what typifies a better user?”

If you want Patient W to have an intelligent conversation with Neurosurgeon X about the various ways to manage Tumor Y you must give W some tools he can use. That doesn’t mean a set of surgical instruments and a “How To Operate On Brains - For Dummies” book.

At Wickenburg Healthcare Alliance (WHA), we have developed a health literacy program based on three major steps to get students from Chopsticks to Chopin. Thus designated and in order of importance, they are:

Start with ABC and do it with elementary and middle school children, avid learners of all things good or bad.  For example, demystify the realm of medicine by visiting a 5th grade class, where you will learn that their biggest concern isn’t whether their HMO will pay for a procedure but how much pain there is when they get a shot. Also they are interested in finding out what’s the most gross thing you have ever seen. Deal with those two concerns, and then start answering other questions which may be, “How does your heart pump blood?”, and, “What happens after you swallow a bite of pizza?”

Then equip these same curious children with materials that help them learn the basics of human anatomy and function. Help them investigate curiosities, and assist them in showing off what they’ve learned at assemblies or health fairs. Encourage them to share new knowledge with their families, who will be surprised to discover what their kids have learned. WHA is doing this.

Once basic concepts are understood, introducing good health living habits (GHL) is simple but vital.  Prevention of disease and maintenance of good health in children are traditionally the responsibility of parents, so when should children take over for themselves?  Do they simply grow up and give these jobs to their healthcare provider of the moment?  Will they follow the Music Man philosophy of learning and magically start doing the right thing at age 16?  Or 18?  Or 22?

Answer: It is never too early for children to develop good habits on their own, regardless of their parents’ attitudes or behaviors.  If kids have knowledge of how their bodies are put together and how they function, they will more likely understand prevention of disease through personal management of lifestyle. WHA is working on this, too.

At the PQR stage, when a person becomes a patient with a problem, passive acceptance of providers’ recommendations is no longer the model to follow, even though that’s the behavior most busy physicians want. Prevention and a healthful lifestyle sometimes fail, and accidents or other disasters may happen. Then it’s time to apply what was learned in Steps ABC and GHL, in a collegial manner, which leads to better choices regarding treatment and more satisfaction for all involved parties. 

A health literate adult faced with, for example, surgery to remove a diseased gall bladder, can ask, “What happens after a heavy meal when I no longer have a gall bladder to do its job?  Will my food digest properly when there is not a squirt of bile to aid digestion of fats?  How will my intestine respond to a constant drip of bile which is no longer side-tracked into the gall bladder for use after a meal?”  Actually, a 5th grade child using our Health Education Primer and other literacy tools can ask those questions and more. It’s always good practice to test your surgeon before he puts you to sleep.  If he doesn’t  know the answers, find one who does.

You may not now be ready to play Chopin but you certainly can listen to it being played by someone else and recognize its beauty. It is also certain that after developing health literacy, you and your children will be far beyond Chopsticks.