Medical Jargon Can Make COVID Health Disparities Even Worse

How Medical Jargon Can Make COVID Health Disparities Even Worse There's a lot of room for dangerous misunderstanding when doctors and public health officials talk to diverse groups about COVID-19. Health literacy projects aim to dispel confusion in all languages. NPR.org

When cases of COVID-19 began rising in Boston last spring, Pooja Chandrashekar, then a first year student at Harvard Medical School, worried that easy-to-understand information about the pandemic might not be available in the many languages spoken by clients of the Family Van, the health services and health literacy program where she was working at the time.

So Chandrashekar recruited more than 175 multilingual health profession students from around the U.S. to start the COVID-19 Health Literacy Project. Its aim: Create clear, understandable information about the virus in more than 40 languages, including English. The group's COVID-19 fact sheets, vetted for accuracy and readability by faculty members who speak and read those languages (the first Urdu effort was deemed too formal), were shared with community organizations around the world. They've been downloaded more 250,000 times so far in over 150 countries.

Each sentence of the fact sheets must be carefully crafted, the volunteers have found, because there is so much room for misunderstanding.

Take for example, the common medical guidance that anyone who thinks they might have COVID-19 should call a doctor.

"Translated incorrectly," Chandrashekar says, "this could be interpreted as 'Don't go to the emergency room until you call your doctor — even if you have symptoms of severe illness.' " And that could, in some cases, be a fatal mistake.

The sudden global appearance in 2020 of COVID-19, a new and often lethal viral illness, has meant the scientific evidence on what to do to prevent and treat the virus has been changing rapidly. Simply keeping up with the latest understanding and guidance has been especially challenging for a number of groups in the U.S. — people who speak little or no English, many older adults, people with limited education or cognitive skills and really anyone who finds the often-opaque language of health care too difficult to understand, says Michael Wolf. He's a professor at Northwestern University Feinberg School of Medicine who studies the ways health communication can go wrong.

"Confusion over what a health provider or website is trying to convey can actually lead to misinformation and mistrust of the very things people need to protect themselves," he says.

The U.S. Department of Health and Human Services defines 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." By that definition, about 14% of Americans are deemed to have "below basic" health literacy, according to Joseph Dexter, a science data fellow at Harvard University. ...

In a review published in August in JAMA Network Open of federal and state web content about the pandemic, Dexter found that content from U.S. government agencies — including the Centers for Disease Control and Prevention and all 50 states — was often pitched higher than the recommended eighth-grade level, making it too hard for millions of Americans to understand fully. ...