Why Teaching About Health Disparities Transforms Communities (Guest Post)

By Kellie Woodson

Kellie Woodson

As an instructional designer, I use my expertise in teaching and learning to create learning experiences on a wide variety of health topics. Whether I’m developing a course on breast cancer genetics  or oral health, a significant part of the process is partnering with experts in the field to develop courses that are informative, engaging and effective.  Since many of these courses are written for frontline health workers, they must also motivate participants to make positive changes in their communities.

Overcoming Barriers to Healthy Choices

A typical course not only provides information on health conditions; it also teaches strategies to effectively guide others in making healthier choices. To do this, it is important to acknowledge the barriers to healthy living that many people face.

For example, we know that regular health checks and healthy eating are important to overall health. But the truth is, getting to the doctor or grocery store can be very difficult for individuals who are disabled, elderly, or who live in rural areas. 

The courses I write challenge participants to acknowledge and reflect on the realities of others that they might otherwise take for granted. How does a person who struggles to get around their own home travel to regular doctor’s visits? How can a person make healthier food choices if they only have access to neighborhood convenience stores?  Does the disproportionate number of tobacco advertisements in low-income communities affect smoking rates in these areas? How does one’s education level affect their ability to complete an application for financial healthcare assistance?

How does a person who struggles to get around their own home travel to regular doctor’s visits? [Tweet this]

The truth is that for many individuals, factors such as age, disability, geographical location and education level pose significant barriers to staying healthy. These barriers in turn give rise to health disparities, or preventable differences in the rate of disease and access to health services among specific groups of people.  While health disparities can and do affect all people, they are more common among minorities and the socio-economically disadvantaged.

When writing a tobacco cessation course for the state of Washington’s Community Health Worker Training program, I learned that African Americans, Asian Americans, members of the LGBT community and American Indians use tobacco products in disproportionate numbers when compared to other groups in Washington.

Across the nation, individuals with lower income and education levels are also more likely to use tobacco.  These disparities then give rise to tobacco-related illness and disease. Due to the lack of quality health care, individuals living in rural areas, those who are living at or below the poverty line and those who have lower education levels are more likely to die as a result of tobacco-related disease.   

Health Disparities Reach Farther Than You Think

It’s important to understand that health disparities aren’t simply the result of groups of people making bad choices. Disparities are systemic, complex and cyclical in nature. For example, groups of people who migrated to the U.S. have been found to have high rates of mental disorder and trauma due to the hardships they experienced during migration.  Racism and oppression often result in trauma-related mental illness. To make matters worse, marginalized groups of people often avoid diagnosis and treatment which further perpetuates these disparities. Consider these statistics:

  • Asian-American women over age 65 have the highest suicide rate of all similarly-aged women in the United States.
  • LGBT youth are about 2 1/2 times more likely to attempt suicide than their peers.
  • Only about ten percent of physicians practice in rural America.
  • People who live and work in low socioeconomic circumstances have an increased risk for mortality, unhealthy behaviors, reduced access to health care and low quality of care.
  • Due to trauma experienced before and after immigration to the United States, Southeast Asian refugees have an increased risk for posttraumatic stress disorder.
  • Native Hawaiians and Pacific Islanders are 30 percent more likely to be diagnosed with cancer than whites.
  • Close to a third of Hispanics get regular health care, including those with chronic health conditions.
  • African-American adults with cancer are significantly less likely to survive prostate cancer, breast cancer and lung cancer than their white counterparts.

These alarming statistics only represent a small fraction of the disparities that exist in our country. Remember that health disparities are found in every group in the U.S. and in every part of the body.

Frontline Health Workers and Communities

Being a frontline health worker is not just about giving guidance and advice– it’s a call to action and advocacy. These people and their employers their community members better than anyone else, and they understand the communities’ challenges, weaknesses and strengths.  As they educate and guide clients to achieving better health, they have the responsibility to acknowledge barriers to care and why they exist. This understanding will help them to better anticipate their client’s needs and respond appropriately and effectively.

Frontline health workers take different paths to solving problems. Many take it upon themselves to create much needed resources and programs in their communities. Others see themselves as organizers who unite members of the community to create solutions where none exist. Whatever the response, you are in the position to make a tremendous impact.

At the end of the day, the goal is to build communities where race, sex, sexual identity, age, disability or socioeconomic status never, ever affect one’s ability to be healthy.

Kellie Woodson is an expert in teaching, learning, and instructional design with content area specialization in health, science, and mathematics. She has extensive experience developing curriculum and learning programs for schools, organizations, and national and international publishers. 

How to Actually Succeed at Behavior Change

Here’s a harsh bit of reality for you: there is no magical method to making healthy lifestyle changes. Fad diets and exercise crazes might make it seem like there is, but they’re wrong. Sad news for the members of your community who want to change thier behavior.

The truth is that the secret to meeting overall health recommendations, from quitting smoking to getting more exercise, is to put one foot in front of the other–and keep doing it. Changing the way you live is simply hard. It just is.

However, there is one technique that actually can make that tough transition easier: setting SMART goals.

SMART Goals

SMART goals break down any task that seems too big to meet by breaking it down into what’s Specific (S) about the goal, how you can Measure (M) it, making it Achievable (A), and also Realistic (R) or Relevant, and setting up a Timeline (T) to complete it.

We talk about SMART goals all the time in our health education materials because they are so effective.  They make big lifestyle changes more manageable.

For example, think about someone who feels overwhelmed by a new diagnosis of hypertension. Their doctor tells them they need to exercise more and lose weight. They might start thinking “I have to run a marathon!” even though they’ve never walked further than the mailbox, or “I need to lose 20 pounds this month!” without considering what needs to change in their diet. Those goals are discouraging and impossible to achieve–a real setback for successful self-management.

Now, when you put a goal like “exercise more” into a SMART format, it changes from “run a marathon” to “walk around the block twice this week.” The difference is huge and makes behavior change something that most people can actually do.

SMART Goals and Behavior Change

Here are some examples of how SMART goals work with different health motivations. To take a SMART approach, they answer these questions (copy them down so you can use them with yourself or a client today):

  • What is Specific about the goal?
  • How will you Measure the goal to know it’s been achieved?
  • Is it Achievable?
  • Is the goal Realistic?
  • Is the goal on a Timeline?

Hypertension

Unspecific goal: “Follow the DASH diet.” The DASH (Dietary Approaches to Stop Hypertension) is a diet that many health providers recommend to patients.

SMART approach: “This week I will eat two cups of fruits and vegetables with dinner and lunch.”

Exercise

Unspecific goal: “Get healthy.” This very fuzzy goal is all too common among people who are trying to build more physical activity into their lives.

SMART approach: “I will meet with a mall walking group on Saturday morning.”

Dieting

Unspecific goal: “Lose 40 pounds.” Many people know they need to lose weight, and even how much, but that’s difficult without a path.

SMART approach: “This month I will lose 5 percent of my current weight. This will allow me to meet my goal by the end of the year.”

Smoking

Unspecific goal: “Stop smoking.” This is a common and clear directive. People need to stop but don’t know how.

SMART approach: “Tomorrow I will replace all the ashtrays in the house with a pack of Nicorette gum.”

Drinking Alcohol

Unspecific goal: “I shouldn’t drink so much.” Breaking through the habit of drinking is hard without a plan.

SMART approach: “I will pick two days this week when I won’t drink.”

Do you see how these short goals seem like something you can do? Meeting one goal makes it easier to move on to a new one. And that is the secret to better health: one step at a time.

Free Ebook: America’s Walking Renaissance

Everybody knows they need to exercise more and eat less. They probably even know that getting some physical activity—even walking for 20 minutescan reduce the chance of getting diseases like heart disease and hypertension, controlling stress and keeping the brain engaged. Plus, studies show that people who spend more time each day sitting (watching TV, driving around or sitting at a desk) are more likely to die early than those who don’t.

That’s all real. We know it, and that’s why we promote health in the communities where we live and work. But then the unrealisitc excuses kick in. That you have to run a marathon to be in shape. That you have to exercise by yourself. That you’ll never be able to fit in another thing with work, school, family…whatever's taking up time.

We need to correct that and show people that you can see real health gains by taking a short walk, and that getting any exercise is better than none.

America’s Walking Renaissance

You don’t have to take my word for it. Listen to Heidi Simon and her colleagues at America Walks and the Every Body Walk! Collaborative, who just released a new (free!) book: America’s Walking Renaissance.

America's Walking Renaissance

America’s Walking Renaissance is a journey across the US, taking a look at walkable cities of all shapes and sizes and providing resources and information on the growing walking movement,” Simon said in an email interview. “From Phoenix to Birmingham to Northeast Iowa, we look at how the US is taking steps towards walkability and look at lessons [from] other communities.”

She, along with Jay Walljasper and Kate Kraft, spent more than a year interviewing, researching and visiting locations all around the States to document successful walking programs. The aim in this project is to share information along with actionable tips, so more organizations and health educators can spark walking programs where they are.

Successful Walking Programs to Copy

A few examples from the free ebook:

Vision Zero, active in more than a dozen cities to reduce the number of walkers who are killed when crossing the street. Vision Zero pushes campaigns through local law enforcement and public education.

Better Bridges Bash, in St. Paul, MN, which puts on street parties in urban environments that are bisected by freeway bridges and overpasses.

Arlington, VA, a success story among suburban cities. Arlington has been named the most walkable suburb in the country. The city transformed itself over years, revamping everything from sidewalk space to accessibility of stores.

“It is our hope that this book will serve as an inspiration for communities looking to embrace walking and motivation for those already on the walking path,” says Simon.

Download the Free Ebook

Download America’s Walking Renaissance for free.

Popular Healthy Community Courses Now Available in Spanish

Release Date: Aug. 1, 2016

Learners can learn about diabetes, health literacy and health insurance in Spanish or English

WOBURN—Talance, Inc., today expanded the reach of its popular courses in health education and promotion. Now, three of the most popular courses are available in Spanish as well as English: Health Literacy: A Start, Navigating Health Insurance and Diabetes and Prediabetes.

The Spanish version of the online courses feature the same interactive curriculua as their English counterparts, and are accessible from nearly any screen from talance.com. They also allow learners to ask questions and have discussions in Spanish. The courses also contain new and updated on-the-job resources available for Spanish speakers.

“Having these courses available in Spanish is a powerful tool for spreading information about these vital health topics,” says Monique Cuvelier, president and co-founder of Talance, which provides training to groups, teams and organizations across the US. Past projects from Talance include courses in Hebrew, French and English as a second language.

“Spanish is the biggest non-English language spoken in this country, and having courses available to this huge swath of the population is important.”

Health Literacy: A Start (Entendiendo la Información Sobre Salud: Primeros Pasos) offers an introduction to health literacy and why it matters, including assessment and communication skills for addressing literacy gaps.

Navigating Health Insurance (Entendiendo los Seguros Médicos) introduces the terms and concepts related to health insurance so participants can help clients get insured.

Diabetes and Prediabetes (Diabetes y Prediabetes) introduces non-clinical community and health workers to diabetes and prediabetes so they can support their clients’ management of the disease.

Talance’s ready-to-go courses take place over one week and feature expert facilitation by fluent Spanish speaking instructors. They’re designed to build healthy communities in schools, worksites, health care and community-based settings. Talance also creates custom curricula for clients who want to build their own healthy communities.

For more information on these courses and other educational materials from Talance, please visit talance.com or contact Monique Cuvelier at (888) 810-9109.