Last week, psychiatrist and sociologist Jonathan Metzl came to Duke University to talk about his book, Dying of Whiteness: How the Politics of Racial Resentment is Killing America’s Heartland. In it, Metzl argues that the racial attitudes of some whites lead them to oppose healthcare policies that could help them live longer. To bring home his point, Metzl first displayed the comments of dying white male patients who said that they opposed the expansion of government-sponsored healthcare because they did not want more benefits going to “Mexicans” and “welfare queens.” He then showed data illustrating a decline in health outcomes in some states where opposition to the Affordable Care Act was strong. Metzl has concluded that many of the white men he interviewed were dying of not just illness but also “ideology.”
Metzl’s talk brought to mind two issues that have come up in the information literacy class I am taking this semester.
One is that of representation. The evoking of the decades-old “welfare queen” image by Metzl’s interviewees speaks to the insidiousness and persistence of radicalized stereotypes, stereotypes often perpetuated by the media.
The second is health literacy. In their publication Healthy People 2010, the U.S. Department of Health and Human Services defined health literacy as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (as cited in United States Department of Health and Human Services, n.d.). Unfortunately, this definition does not address health policy literacy, a timely topic, considering the ongoing contentiousness around the Affordable Care Act.
Researchers Wolbring Gregor, Verlyn Leopatra, and Sophya Yumakulov stressed the importance of health policy literacy in their 2012 article “Information Flow and Health Policy Literacy: The Role of the Media.” Drawing on the work of numerous scholars, they listed three critical components of health policy literacy:
“(a) the understanding of how policies are developed and their social embeddedness; (b) the understanding of the history of presented arguments in a given health policy discourse and the consequences flowing from contemporary arguments used; (c) how policies and their discourses might be impacted by emerging social and scientific and technological developments [19–28].”
On a more basic level, people need to also know who can and cannot receive certain healthcare benefits. Metzl noted that the patients who expressed concerns about “Mexicans” receiving government assistance were most likely referring to undocumented immigrants – yet, as he pointed out, undocumented immigrants are not even eligible for the government-sponsored health benefits that were being discussed.
Certainly, there are well-informed, non-racist people on either side of the universal healthcare debate. Just as certainly, there are times when racist ideology will win out regardless of a person’s knowledge level. That said, many people – myself included – have a limited understanding of health policy and need more education in this area.
Gregor et al. recommend that the media promote health policy literacy by using more “key health policy terms” in their reporting, so that people will know what words to use when searching for information online. This is a good idea, but how do you develop the subject background that you need to conduct the best online searches?
I’m glad you asked. Coursera offers several MOOCs on health policy. The Medical College of Wisconsin Libraries hosts a libguide that links to resources and provides definitions of important health policy terms. The Healthcare.gov site’s Affordable Care Act (ACA) glossary page summarizes the stated goals of ACA, and the site’s Rights and protections page explains the law’s main provisions in everyday language.
For a global perspective, go to the Organization for Economic Cooperation and Development (OECD) website’s “By Country” page. You can click on a country name to access the country’s health data and learn more about its health policies.
I think this is enough to keep us busy for a while. Test your knowledge while you learn by taking some of The Commonwealth Fund’s health policy quizzes. (You can find them by entering “quiz” in the site’s search box.) Here’s one I like:
The Commonwealth Fund’s International Health Policy Quiz
If you come across other useful resources, please send them to me!
Like what you read? If so, tell others about it via social media, through email, or by word of mouth.
References
Gregor, W., Leopatra, V., Yumakulov, S. (2012). Information flow and health policy literacy: The role of the media. Information; Volume 3; Issue 3; Pages 391-402. http://dx.doi.org/10.3390/info3030391
United States Department of Health and Human Services. (n.d.). Quick Guide to Health Literacy. Retrieved from https://health.gov/communication/literacy/quickguide/factsbasic.htm#one
Copyright © 2019 by Stacy Torian. All rights reserved.
Stacy Torian 