13 thoughts on “Strategic Communication for Public Health”
This week’s readings covered the relationship between advocacy and public health. The first reading discussed the political context of public health and the tension of its values. As public health practitioners we know that the social and economic environment one lives in has a major impact on their health. This reading points out that this fundamental concept highlights that public health has political ties, as the political realm sets the policies that create the social and economic environment of a particular community. Understanding this relationship is key to being able to come up with and work towards solutions for public health issues and concerns. This reading also discussed the dichotomous relationship between market justice and social justice. Last spring, I took Social Justice and Public Health as an elective and this was something we discussed throughout the course. I think that the ideals of market justice often work directly against public health. These ideals of individualism and self-responsibility are a strong narrative in America that prevent people from wanting to contribute to the collective good. This narrative places blame on the so called “victims†rather than the social and economic environment, thus making it their own fault that they did not work hard enough to deserve better health and opportunities. It is a real challenge that public health practitioners have to work against. While the course I took was an elective I think that social justice is a real cornerstone of public health. Health equity and social justice cannot be left out of the conversation. This is especially true for advocacy, which the second reading focused on. This reading discussed how public health advocates should increase the capacity of a community to participate more fully in determining their own issues and developing and implementing strategies to address these issues. During this process public health practitioners should be considering the political context that is creating barriers and prepare to advocate with the community for change. This reading also discussed the role of power; I really liked how the authors critically examined the term “empowerment,†something I hadn’t done before. “The term empowerment, too, assumes that someone is conferring power on another, that the empowerer is giving something that the empoweree did not already possess. Instead of saying that a group was empowered by a project one might more accurately say that the project facilitated the claiming of power by the group.†Language and the words we choose can convey meaningful and impactful messages and this was just one example of how a small shift can give a whole new context and connotation.
The first reading this week, Public Health and Media Advocacy, resonated with many of the public health classes I have taken in the past, as well as with some resource economics courses I took for my minor in undergrad. It was in these classes that I first learned about market justice versus social justice, and while we did not go as in depth as this reading did, I remember thinking how harsh and unfair market justice is. However, that is also the system that the United States operates on, and it goes hand in hand with our capitalist society. Social justice places a greater emphasis on the distribution of resources in society and whether or not this distribution is fair. Market justice, on the other hand, really does not care if the distribution is fair. Market justice is rooted in individualism. If something is not fair, then it is seen as your own fault, and it is something you should have worked harder to achieve. When it comes to our society, I think this is one of our biggest downfalls: placing individual blame on people for issues that they have little to no control over. As the river analogy demonstrated, changing individual behavior is not enough because it is not the root of the issue. When the root of the issue is tangled up with social and political issues, it sometimes makes it feel like it’s impossible to really solve anything. I think a prime example is with the obesity our country. It is not due to individual choice that people are developing obesity. It is the USDA subsidizing corn and soy, two of the most important products in the fast food and junk food industries. It is cities not being walkable, food deserts, lack of public transportation, a minimum wage that isn’t livable. Everything is connected in public health. There is so much out of our control and so many ways in which big businesses influence our lives, but it is easy to fall into the mindset of victim blaming. Using media advocacy allows people to have a voice, to be heard along with these big corporations, and to access ways to participate.
These readings are similar in nature, and one key point they both come back to is the different levels of power within our society. In the Advocacy Connection, they state that advocacy is used to “make institutions more responsive to human needs†(pg. 28). At the end of the day, if corporations didn’t put people before profits, we wouldn’t have many of the issues we are currently facing. Since that is not the case, we need media advocacy to bring the people up to the level at which these big corporations are fighting on. One example that I thought was interesting in Advocacy Connection was about the LA riots and issue with alcohol in the community. In this section, they mentioned the issue between Korean American store owners and African American residents of the community. There became an ‘us’ and ‘them’, which is something I vividly remember from a documentary on Rodney King. Through advocacy efforts, they helped the two sides see that the other was not the enemy, that there were greater powers at play here. Advocacy allows us to see who is truly responsible for the issues at hand. This ‘us’ and ‘them’ made me think of the introductory GEO meeting, where they told us the university wants to start shifting towards making graduate assistantships for Ph.D students only. Without looking at the larger picture, it could be easy for a masters students and Ph.D students to fight amongst each other, blaming one group for taking all the jobs. However, nothing would be accomplished by this, because the Ph.D students are not the one creating these changes to begin with.
One section of the first reading that really stuck out to me was the part about how poor health is often not a result of a personal choice, but the effect of social and economic situations that the individual has little control over. I related this back to audiology by thinking about how hearing loss is something many individuals have no control over, yet they are often treated differently because of their disability. I thought the section on victim blaming and how personal responsibility is embedded in United States culture was so important. Issues that result from hearing loss, such as communication barriers, are often put on the person with the loss and the other individual in the conversation seldom takes the blame for the communication breakdown. However, individuals with hearing loss are often working twice as hard to overcome barriers in communication and should not be blamed when someone else is covering their mouth while talking or talking too quickly while not facing the person they are talking to. I think some of the ideas in this reading are helpful to think about as someone who is going to be responsible for advocating for patients with hearing loss. Since people with hearing loss often have no control over their loss, it is important to think about ways that society can change to help these individuals rather than just focusing on what individuals can do when they are stuck in a society that does not understand them.
The second reading helped me focus on what I need to think about as someone advocating for individuals with hearing loss. As an undergrad, we did a lot of activities to spread awareness about communication and individuals with hearing loss. As I was reading, I was thinking of ways we could have improved our activities to better advocate for individuals with hearing loss. The reading mentioned key characteristics of advocacy, which included assuming people have rights and those rights are enforceable, focusing on something specific and focusing on a community where rights are already entitled. I think one way we could have improved our activities would be to focus on one specific issue that people with hearing loss face and try to spread awareness of how to improve that issue, rather than being very broad and trying to solve every issue. I think it also would have been helpful to have data available to show students how changing their attitudes and behaviors around people with hearing loss can have positive results on communication. I also really liked the section that talked about referring to an individual as someone with a disability, rather than a disabled person because that is something that audiologists hear a lot.
The readings for this week provided a clear description of the difference between placing the responsibility for health with the individual versus with the community. The description of the market justice ethic was especially useful because it linked ingrained American ideals to attitudes about health. The first reading suggests breaking down the belief that the victim is “other” in part by emphasizing the large numbers of people impacted (across different demographics, if possible) or improving the visibility of local people’s stories. This helps others in the community feel more connected to the issue and more likely to support the intervention. The second reading built upon this idea by highlighting the importance of a strong foundation of formative research to support advocacy efforts. In addition to collecting information to characterize the people at risk, it helps to have details about the source of the problem and any costs to the community as a whole. The second reading also discussed the advantage of focusing advocacy efforts at a local level as a way to set manageable goals and pick many smaller fights that could eventually lead to national or global policy changes.
Public health problems can usually be traced back to poverty, racism, lack of education, and hopelessness. Even though I know this, I sometimes catch myself thinking that this does not apply to vector-borne diseases. Ticks and mosquitos do not distinguish between people from different socioeconomic statuses, but it seems likely that people without adequate health insurance would be less likely to seek treatment quickly. Because of this delay in seeking medical care, we can expect to see people of lower socioeconomic status be more likely to have higher morbidity or loss of productive years due to vector-borne diseases. In addition, people with less money are less likely to be able to afford preventative measures such as pre-treated clothing or spend the time or money to keep their yards relatively tick or mosquito-free.
As Sarah mentioned in her post, the first reading brought up an interesting point about the language we use to describe public health interventions. I had never thought about how the word “empower†could be contributing to power dynamics and racism, which further disadvantages the groups of people that we are trying to help.
The first of this week’s readings introduced the concept of social marketing and advocacy. The author discusses how healthcare has become focused on the individual’s responsibility in their health rather than outside factors. This is integrated with victim blaming. For example, someone who is addicted to prescription pain killers may be blamed for their addiction instead of the pharmaceutical company. Healthcare and access to healthcare has also been treated as a reward for work rather than a right. However, a shift to a more social justice view of healthcare makes way for social marketing, which aims to reach people regarding their health. When reading, I tried to consider a situation which might relate to my work as an audiologist. I began to think about hearing loss due to noise exposure. Many people expose themselves to noise both recreationally and occupationally, and it would be easy to blame them for not taking precautions to protect their hearing. However, if one considers outside factors, such as lack of access to information about hearing health or jobs that might not adhere to OSHA standards, the issue becomes more multifaceted.
The second reading highlighted the need to be an advocate and how advocacy works. Much of an audiologist’s work, especially in educational settings, involves being an advocate for patients. This means helping them get certain accommodations that will improve their quality of life as it relates to their hearing and communication needs. I especially enjoyed the section on setting advocacy goals. I could see myself utilizing this information to discuss with a patient what their needs are and creating clear goals for them. Then I could advocate for them in a number of ways, whether that be contacting a school or business to make the case for supportive systems, making sure OSHA regulations are being kept, or contacting insurance companies about paying for assistive devices.
This week’s readings were about media advocacy and public health. A part of the reading that stuck out to me was on page 6 and said, “for the vast majority of people in our society the life circumstances leading to poor health are not adopted as a matter of personal choice, but are thrust upon people by the social and economic circumstances into which they are born.†This is such an important concept to understand because in American society it is so easy for people to blame the individual for their health issues without acknowledging how systemic issues may be contributing to their health issues. This makes me think about a discussion I had in a class I took during my undergrad, Health Inequities. In this discussion we talked about how one’s environment can you tell more about the health of an individual than the individual’s DNA. This is because an environment can tell you about the individual’s access to fresh fruits and vegetables, the quality of infrastructure, social class and access to other resources which all contribute to the health of an individual. This concept of focusing on the individual was highlighted in the section on market justice. In market justice, they blame the victim. Exceptionalism is the idea that the problems individuals face are due to individual failure and are structural failures. Because this idea is so ingrained into the society we live in, we inevitably try to create change on the individual level and not on the social and structural level and that needs to be changed. As a community health worker at a community health center, I think it is important for me to understand how the system fails people and to not feed into the idea that the health of the individual is solely based on their individual behavior. Market justice is what causes internal oppression. When individuals are being told so many times that it is their fault that they have certain health issues, they start to believe the stereotype and believe that they cannot break the cycle and that they cannot change. I think it is important to empower marginalized groups so we can break that internalized oppression and see health as a social phenomenon and not an individual one.
The second reading was on how advocacy works to create change. As a community health worker, I have to advocate for things my patients should have rights to, such as healthy affordable food. A lot of our diabetic patients voiced their concerns about having enough to eat and having healthy food. We as a group had to advocate for them to have access to healthy foods. Patients who were on snap eventually were able to get some fresh fruits and vegetables from a farmer’s market stand in front of the health center at no cost. If they completed a “walking for wellness program†they received vouches for more fruits and vegetables which not only made them want to walk and exercise but helped alleviate many of their concerns.
This week’s reading on strategic communication for public health covered topics related to advocacy. In Chapter 1, I felt that the reading addressed several profound elements that are pertinent to public health including market justice, victim blaming, and the environmental perspective to name a few. All of these elements together characterize the underlying principles and tension of values of public health that are often overlooked or just simply not considered. In short, the reading argues that many public health issues exist and persist as a result of unfair societal structures. This might be evident from the case that women are often blamed for their own assault as a consequence of their own actions and not the society that allows the assault to happen, or that low income areas are typically subject to public health concerns so policy is directed toward these areas but little is done in terms of legislation to improve these areas so that health concerns are not tackles at a societal structural level. This discussion in the reading encouraged me to consider how these principles may impact individuals with hearing loss as it relates to the field of audiology and cultural concerns of the Deaf community.
In the matter of young children with hearing loss, the early detection and implementation of a rehabilitation plan is detrimental. Children under the age of three are in a critical period for language development, so knowing that one might have a hearing loss is crucial for future growth milestones. On the one hand, a child who is born to a family with reasonable income and in an environment that has at least adequate health services will likely have their hearing loss detected early and will be able to afford a suitable rehabilitation plan from an audiologist that might include hearing aids or even a cochlear implant (which are very pricy especially without insurance.) On the other hand, a child born into a low income family in an environment that lacks sufficient health services might suffer developmentally as their hearing loss went undetected for a significant amount of time and the family cannot afford the services needed for rehabilitation. This is not at the fault of anyone but the structural system that makes it so difficult for a low income family is an impoverished environment to receive fundamental health services.
As a future clinician, it is imperative that I have this awareness so that I can not only be a more compassionate professional, but also so that I can act as an advocate for my clients, as mentioned in chapter 2. Advocacy is so important in the professional health field because there are so many individuals out there who are in desperate need of services, cannot reach them, and do not have a voice to advocate for themselves. I hope to be able to advocate for those in need of the health services that I will provide in the future because I know how crucial they can sometimes be.
This was my first time learning about the term “market justice”, but it fits very well in with the negatives I have already learned about, when shifting the blame and responsibility to the individual while ignoring the greater social context which contributes to their less than optimal health state. A powerful quote they have in there is “If the people are abuse it is because they chose self-abuse.” Which is a completely absurd statement when worded like that, yet so many individuals will make statements almost exactly like that when referring to those who suffer from very real medical conditions.
The prevalence in our culture of the market justice belief system along with victim blaming is probably demonstrated best in how people treat those who suffer from substance abuse disorder. There is a strong belief that is it an individual’s own personal moral failing for using injectable drugs, and when they come in with life and health threatening emergencies there are always those who make negative comments about their character. One patient said to me, “It’s just not fair that I have to listen to people overdosing in the next room. I’m here fighting for my life, while others are just throwing theirs away. I’m not saying that some lives are more valuable than others….. I just can’t be in this place anymore.”
This week’s readings took a closer and more specific look at public health issues and the use of media advocacy. The first reading addressed the innovative use of mass media to promote public health. There were four underlying principles of media advocacy that were covered; the political context of public health, competition and market justice, an upstream approach, and the importance of the consumer being involved. Public health is entangled in politics and there has to be a shift away from health being an individuals’ problem to making it a social policy issue. In order to make that shift we must address the population health determinants that are making people sick. Population health determinants are brought up in almost every public health class and I took an entire course on them in undergrad. Population health determinants are the things that impact health that have nothing to do with individual behavior, like income, where someone lives, and access to healthcare. A lot of the time these things are what people are born into. Blaming the victim of a health issue is not going to get at the root of the problem or prevent others from getting sick. Prevention has to come from a place that sees problems as a societal problem and that need to be changed by policy. This approach is often referred to as upstream and this was also brought up in the reading. A person’s social and economic environment is the largest determinant of their health.
The second reading focuses specifically on advocacy and what that really is. The reading defines advocacy as, “a catch-all word for the set of skills used to create a shift in public opinion and mobilize the necessary resources and forces to support an issue, policy, or constituencyâ€. Advocacy is all about empowering people to have their voice heard so changes can happen on an institutional level. The process of advocacy and media advocacy aimed at public health issues follows very similar steps as health communication campaigns as a whole that we have previously read about. They need to be based in credible data, have specific and attainable goals set, and have a clear channel for giving the message. Advocacy is the upstream approach in which the root problems/population health determinants can be addressed.
The first reading gave an overview of public health and media advocacy. This reading reminded me of my current supervisor’s saying that she decided to go in the public health field because she wanted to save the world. Like the Adam and Eve story and its three perceptive, in public health all three professions matter equally and work interdependently. The idea that advocacy turns disease from an individual problem to a communal problem is major especially in a market driven society such as the US. For this reason, I believe advocacy works against market justice. My strong belief in this stems from my sociological background from my undergrad major. This reading also talked about blaming the victim. Although, society as a whole has a lot of exceptionalism beliefs, there has been some progress. For example, the emergency room not being able to turn away those in emergency situation regardless of their financial status.
The second reading focused heavily on advocacy. While reading this section, I was constantly thinking about social justice work because of the planning process and assessment aspect but realized that public health advocacy is much more respected than social justice work but they go hand in hand; society just has a much different view because there is science that usually backs up public health.
I was drawn in quickly to the first reading, “Public Health and Media Advocacy,” when I read this sentence on page 4: “Public health is essentially political.” I have never thought of public health in this way before, and I think it is an incredibly interesting way to frame public health work. As discussed in the article, it may seem like most health issues are caused by biology or individual choices; however, in reality, the issues are caused by underlying social and economic conditions. Because the government has direct influence on the social and economic conditions, public health is inextricable from politics. It is often difficult for me to understand why individuals in power would support policies and programs that contribute to the worsening of peoples health. This was an important reminder that many of these actions are politically motivated. Instead of shying away from becoming political, I should embrace this as a way to make a wide impact.
The discussion about market justice reminded me of posts that I see online frequently asking people to donate money for medical expenses. A simple search on GoFundMe turns up thousands of medicine-related fundraisers. When a community rallies together to help someone with these expenses, it is praised and widely publicized. However, it is much less frequently that I see people asking the question, “Why do those in need have to depend on the welfare of individuals?”
The second reading, “The Advocacy Connection,” gave more specific information about how public health advocacy can be conducted. I appreciated the recognition that often advocacy is an uphill battle. For example, advocacy can be threatening to corporate interests, and public health organizations often do not have the monetary resources to match those of the corporations. I would be interested to learn more about coalitions like the Milwaukee Coalition Against Drug and Alcohol Abuse and how they are able to attract such large amounts of high-quality participation. I think that one of the most useful skills I will need in my future endeavors is learning to organize and motivate individuals to participate in community health education programs, so I enjoyed reading about such a successful example.
This week’s readings discussed strategic health communication. Both readings provide a lot of stories and anecdotes about how to strategically talk about health with others. The first chapter goes into media advocacy, and how it lets the story be told from a public health perspective. One thing that really stood out in this reading was the concept of victim-blaming, and how it can be a consequence of media advocacy. If it is done incorrectly, media advocacy can lead to overanalysis of a problem and may cause one to place blame on an individual, instead of helping them.
The concept of advocacy continues in the second chapter. Advocacy is described as a way to support others. The story about the person drowning was a great example of how certain methods may seem helpful, but may not fit the needs of the situation. The authors talk about identifying “experts” in the community, and how it is important to give these individuals an “authentic voice”. Experts can range from a wide variety of people, but when working in public health, the experts are usually members of the community. The idea of an “authentic voice” helps to humanize the issue at hand. This made me think about the campaign we saw last week during class. The initiatives used real stories of people who suffered from opioid addiction. This tactic was used to draw attention to the issue. The chapter continues by saying that this method should be used with caution. Who we define as “experts” can have a significant impact. Identifying some individuals over others can potentially be stereotypical and limiting. The authors encourage us to be mindful of this and to incorporate these practices into our advocacy work.
I’ve always been a social justice advocate and when working within Public Health I believe it is crucial to support social justice. I think social justice and health equity (what we should try to achieve) go hand in hand because it is the fairest and many deep-rooted issues arise from socioeconomic status. However, this was the first time I came across the term market justice which is based on “key assumptions that largely determine the acceptable range of approaches to public health problems.†(pg 6). It is about thinking of problems as an individual and a person being able to have control over one’s life and circumstances. For example, “market justice suggests that benefits such as health care, adequate housing, nutrition, and sustainable employment are rewards for individual effort (on a level of the playing field), rather than goods and services that society has an obligation to provide.†(pg 8). I strongly disagree with this because people don’t have full control over their lives and the situations and circumstances that they face. Everyone does not start on an equal playing field.
Working as a Program Coordinator at Boston Children’s Hospital, I witnessed that not everyone gets the same quality of care mainly due to their insurance but also secondary factors such as race and education level of parent/guardian. Many people are turned away due to the poor quality of coverage their insurance provides so I don’t think the U.S. Health Care System is doing its best in terms of caring for their people. Health care is not a right here in the states but rather a privilege. Moving on to the second reading which was mainly about health advocacy, it is our job especially as community health educators to advocate the rights for our communities; especially vulnerable populations. The reading generalizes the term of advocacy but advocacy can happen on all levels and sometimes the grassroots level can be the most effective and most impactful.
This week’s readings covered the relationship between advocacy and public health. The first reading discussed the political context of public health and the tension of its values. As public health practitioners we know that the social and economic environment one lives in has a major impact on their health. This reading points out that this fundamental concept highlights that public health has political ties, as the political realm sets the policies that create the social and economic environment of a particular community. Understanding this relationship is key to being able to come up with and work towards solutions for public health issues and concerns. This reading also discussed the dichotomous relationship between market justice and social justice. Last spring, I took Social Justice and Public Health as an elective and this was something we discussed throughout the course. I think that the ideals of market justice often work directly against public health. These ideals of individualism and self-responsibility are a strong narrative in America that prevent people from wanting to contribute to the collective good. This narrative places blame on the so called “victims†rather than the social and economic environment, thus making it their own fault that they did not work hard enough to deserve better health and opportunities. It is a real challenge that public health practitioners have to work against. While the course I took was an elective I think that social justice is a real cornerstone of public health. Health equity and social justice cannot be left out of the conversation. This is especially true for advocacy, which the second reading focused on. This reading discussed how public health advocates should increase the capacity of a community to participate more fully in determining their own issues and developing and implementing strategies to address these issues. During this process public health practitioners should be considering the political context that is creating barriers and prepare to advocate with the community for change. This reading also discussed the role of power; I really liked how the authors critically examined the term “empowerment,†something I hadn’t done before. “The term empowerment, too, assumes that someone is conferring power on another, that the empowerer is giving something that the empoweree did not already possess. Instead of saying that a group was empowered by a project one might more accurately say that the project facilitated the claiming of power by the group.†Language and the words we choose can convey meaningful and impactful messages and this was just one example of how a small shift can give a whole new context and connotation.
The first reading this week, Public Health and Media Advocacy, resonated with many of the public health classes I have taken in the past, as well as with some resource economics courses I took for my minor in undergrad. It was in these classes that I first learned about market justice versus social justice, and while we did not go as in depth as this reading did, I remember thinking how harsh and unfair market justice is. However, that is also the system that the United States operates on, and it goes hand in hand with our capitalist society. Social justice places a greater emphasis on the distribution of resources in society and whether or not this distribution is fair. Market justice, on the other hand, really does not care if the distribution is fair. Market justice is rooted in individualism. If something is not fair, then it is seen as your own fault, and it is something you should have worked harder to achieve. When it comes to our society, I think this is one of our biggest downfalls: placing individual blame on people for issues that they have little to no control over. As the river analogy demonstrated, changing individual behavior is not enough because it is not the root of the issue. When the root of the issue is tangled up with social and political issues, it sometimes makes it feel like it’s impossible to really solve anything. I think a prime example is with the obesity our country. It is not due to individual choice that people are developing obesity. It is the USDA subsidizing corn and soy, two of the most important products in the fast food and junk food industries. It is cities not being walkable, food deserts, lack of public transportation, a minimum wage that isn’t livable. Everything is connected in public health. There is so much out of our control and so many ways in which big businesses influence our lives, but it is easy to fall into the mindset of victim blaming. Using media advocacy allows people to have a voice, to be heard along with these big corporations, and to access ways to participate.
These readings are similar in nature, and one key point they both come back to is the different levels of power within our society. In the Advocacy Connection, they state that advocacy is used to “make institutions more responsive to human needs†(pg. 28). At the end of the day, if corporations didn’t put people before profits, we wouldn’t have many of the issues we are currently facing. Since that is not the case, we need media advocacy to bring the people up to the level at which these big corporations are fighting on. One example that I thought was interesting in Advocacy Connection was about the LA riots and issue with alcohol in the community. In this section, they mentioned the issue between Korean American store owners and African American residents of the community. There became an ‘us’ and ‘them’, which is something I vividly remember from a documentary on Rodney King. Through advocacy efforts, they helped the two sides see that the other was not the enemy, that there were greater powers at play here. Advocacy allows us to see who is truly responsible for the issues at hand. This ‘us’ and ‘them’ made me think of the introductory GEO meeting, where they told us the university wants to start shifting towards making graduate assistantships for Ph.D students only. Without looking at the larger picture, it could be easy for a masters students and Ph.D students to fight amongst each other, blaming one group for taking all the jobs. However, nothing would be accomplished by this, because the Ph.D students are not the one creating these changes to begin with.
One section of the first reading that really stuck out to me was the part about how poor health is often not a result of a personal choice, but the effect of social and economic situations that the individual has little control over. I related this back to audiology by thinking about how hearing loss is something many individuals have no control over, yet they are often treated differently because of their disability. I thought the section on victim blaming and how personal responsibility is embedded in United States culture was so important. Issues that result from hearing loss, such as communication barriers, are often put on the person with the loss and the other individual in the conversation seldom takes the blame for the communication breakdown. However, individuals with hearing loss are often working twice as hard to overcome barriers in communication and should not be blamed when someone else is covering their mouth while talking or talking too quickly while not facing the person they are talking to. I think some of the ideas in this reading are helpful to think about as someone who is going to be responsible for advocating for patients with hearing loss. Since people with hearing loss often have no control over their loss, it is important to think about ways that society can change to help these individuals rather than just focusing on what individuals can do when they are stuck in a society that does not understand them.
The second reading helped me focus on what I need to think about as someone advocating for individuals with hearing loss. As an undergrad, we did a lot of activities to spread awareness about communication and individuals with hearing loss. As I was reading, I was thinking of ways we could have improved our activities to better advocate for individuals with hearing loss. The reading mentioned key characteristics of advocacy, which included assuming people have rights and those rights are enforceable, focusing on something specific and focusing on a community where rights are already entitled. I think one way we could have improved our activities would be to focus on one specific issue that people with hearing loss face and try to spread awareness of how to improve that issue, rather than being very broad and trying to solve every issue. I think it also would have been helpful to have data available to show students how changing their attitudes and behaviors around people with hearing loss can have positive results on communication. I also really liked the section that talked about referring to an individual as someone with a disability, rather than a disabled person because that is something that audiologists hear a lot.
The readings for this week provided a clear description of the difference between placing the responsibility for health with the individual versus with the community. The description of the market justice ethic was especially useful because it linked ingrained American ideals to attitudes about health. The first reading suggests breaking down the belief that the victim is “other” in part by emphasizing the large numbers of people impacted (across different demographics, if possible) or improving the visibility of local people’s stories. This helps others in the community feel more connected to the issue and more likely to support the intervention. The second reading built upon this idea by highlighting the importance of a strong foundation of formative research to support advocacy efforts. In addition to collecting information to characterize the people at risk, it helps to have details about the source of the problem and any costs to the community as a whole. The second reading also discussed the advantage of focusing advocacy efforts at a local level as a way to set manageable goals and pick many smaller fights that could eventually lead to national or global policy changes.
Public health problems can usually be traced back to poverty, racism, lack of education, and hopelessness. Even though I know this, I sometimes catch myself thinking that this does not apply to vector-borne diseases. Ticks and mosquitos do not distinguish between people from different socioeconomic statuses, but it seems likely that people without adequate health insurance would be less likely to seek treatment quickly. Because of this delay in seeking medical care, we can expect to see people of lower socioeconomic status be more likely to have higher morbidity or loss of productive years due to vector-borne diseases. In addition, people with less money are less likely to be able to afford preventative measures such as pre-treated clothing or spend the time or money to keep their yards relatively tick or mosquito-free.
As Sarah mentioned in her post, the first reading brought up an interesting point about the language we use to describe public health interventions. I had never thought about how the word “empower†could be contributing to power dynamics and racism, which further disadvantages the groups of people that we are trying to help.
The first of this week’s readings introduced the concept of social marketing and advocacy. The author discusses how healthcare has become focused on the individual’s responsibility in their health rather than outside factors. This is integrated with victim blaming. For example, someone who is addicted to prescription pain killers may be blamed for their addiction instead of the pharmaceutical company. Healthcare and access to healthcare has also been treated as a reward for work rather than a right. However, a shift to a more social justice view of healthcare makes way for social marketing, which aims to reach people regarding their health. When reading, I tried to consider a situation which might relate to my work as an audiologist. I began to think about hearing loss due to noise exposure. Many people expose themselves to noise both recreationally and occupationally, and it would be easy to blame them for not taking precautions to protect their hearing. However, if one considers outside factors, such as lack of access to information about hearing health or jobs that might not adhere to OSHA standards, the issue becomes more multifaceted.
The second reading highlighted the need to be an advocate and how advocacy works. Much of an audiologist’s work, especially in educational settings, involves being an advocate for patients. This means helping them get certain accommodations that will improve their quality of life as it relates to their hearing and communication needs. I especially enjoyed the section on setting advocacy goals. I could see myself utilizing this information to discuss with a patient what their needs are and creating clear goals for them. Then I could advocate for them in a number of ways, whether that be contacting a school or business to make the case for supportive systems, making sure OSHA regulations are being kept, or contacting insurance companies about paying for assistive devices.
This week’s readings were about media advocacy and public health. A part of the reading that stuck out to me was on page 6 and said, “for the vast majority of people in our society the life circumstances leading to poor health are not adopted as a matter of personal choice, but are thrust upon people by the social and economic circumstances into which they are born.†This is such an important concept to understand because in American society it is so easy for people to blame the individual for their health issues without acknowledging how systemic issues may be contributing to their health issues. This makes me think about a discussion I had in a class I took during my undergrad, Health Inequities. In this discussion we talked about how one’s environment can you tell more about the health of an individual than the individual’s DNA. This is because an environment can tell you about the individual’s access to fresh fruits and vegetables, the quality of infrastructure, social class and access to other resources which all contribute to the health of an individual. This concept of focusing on the individual was highlighted in the section on market justice. In market justice, they blame the victim. Exceptionalism is the idea that the problems individuals face are due to individual failure and are structural failures. Because this idea is so ingrained into the society we live in, we inevitably try to create change on the individual level and not on the social and structural level and that needs to be changed. As a community health worker at a community health center, I think it is important for me to understand how the system fails people and to not feed into the idea that the health of the individual is solely based on their individual behavior. Market justice is what causes internal oppression. When individuals are being told so many times that it is their fault that they have certain health issues, they start to believe the stereotype and believe that they cannot break the cycle and that they cannot change. I think it is important to empower marginalized groups so we can break that internalized oppression and see health as a social phenomenon and not an individual one.
The second reading was on how advocacy works to create change. As a community health worker, I have to advocate for things my patients should have rights to, such as healthy affordable food. A lot of our diabetic patients voiced their concerns about having enough to eat and having healthy food. We as a group had to advocate for them to have access to healthy foods. Patients who were on snap eventually were able to get some fresh fruits and vegetables from a farmer’s market stand in front of the health center at no cost. If they completed a “walking for wellness program†they received vouches for more fruits and vegetables which not only made them want to walk and exercise but helped alleviate many of their concerns.
This week’s reading on strategic communication for public health covered topics related to advocacy. In Chapter 1, I felt that the reading addressed several profound elements that are pertinent to public health including market justice, victim blaming, and the environmental perspective to name a few. All of these elements together characterize the underlying principles and tension of values of public health that are often overlooked or just simply not considered. In short, the reading argues that many public health issues exist and persist as a result of unfair societal structures. This might be evident from the case that women are often blamed for their own assault as a consequence of their own actions and not the society that allows the assault to happen, or that low income areas are typically subject to public health concerns so policy is directed toward these areas but little is done in terms of legislation to improve these areas so that health concerns are not tackles at a societal structural level. This discussion in the reading encouraged me to consider how these principles may impact individuals with hearing loss as it relates to the field of audiology and cultural concerns of the Deaf community.
In the matter of young children with hearing loss, the early detection and implementation of a rehabilitation plan is detrimental. Children under the age of three are in a critical period for language development, so knowing that one might have a hearing loss is crucial for future growth milestones. On the one hand, a child who is born to a family with reasonable income and in an environment that has at least adequate health services will likely have their hearing loss detected early and will be able to afford a suitable rehabilitation plan from an audiologist that might include hearing aids or even a cochlear implant (which are very pricy especially without insurance.) On the other hand, a child born into a low income family in an environment that lacks sufficient health services might suffer developmentally as their hearing loss went undetected for a significant amount of time and the family cannot afford the services needed for rehabilitation. This is not at the fault of anyone but the structural system that makes it so difficult for a low income family is an impoverished environment to receive fundamental health services.
As a future clinician, it is imperative that I have this awareness so that I can not only be a more compassionate professional, but also so that I can act as an advocate for my clients, as mentioned in chapter 2. Advocacy is so important in the professional health field because there are so many individuals out there who are in desperate need of services, cannot reach them, and do not have a voice to advocate for themselves. I hope to be able to advocate for those in need of the health services that I will provide in the future because I know how crucial they can sometimes be.
This was my first time learning about the term “market justice”, but it fits very well in with the negatives I have already learned about, when shifting the blame and responsibility to the individual while ignoring the greater social context which contributes to their less than optimal health state. A powerful quote they have in there is “If the people are abuse it is because they chose self-abuse.” Which is a completely absurd statement when worded like that, yet so many individuals will make statements almost exactly like that when referring to those who suffer from very real medical conditions.
The prevalence in our culture of the market justice belief system along with victim blaming is probably demonstrated best in how people treat those who suffer from substance abuse disorder. There is a strong belief that is it an individual’s own personal moral failing for using injectable drugs, and when they come in with life and health threatening emergencies there are always those who make negative comments about their character. One patient said to me, “It’s just not fair that I have to listen to people overdosing in the next room. I’m here fighting for my life, while others are just throwing theirs away. I’m not saying that some lives are more valuable than others….. I just can’t be in this place anymore.”
This week’s readings took a closer and more specific look at public health issues and the use of media advocacy. The first reading addressed the innovative use of mass media to promote public health. There were four underlying principles of media advocacy that were covered; the political context of public health, competition and market justice, an upstream approach, and the importance of the consumer being involved. Public health is entangled in politics and there has to be a shift away from health being an individuals’ problem to making it a social policy issue. In order to make that shift we must address the population health determinants that are making people sick. Population health determinants are brought up in almost every public health class and I took an entire course on them in undergrad. Population health determinants are the things that impact health that have nothing to do with individual behavior, like income, where someone lives, and access to healthcare. A lot of the time these things are what people are born into. Blaming the victim of a health issue is not going to get at the root of the problem or prevent others from getting sick. Prevention has to come from a place that sees problems as a societal problem and that need to be changed by policy. This approach is often referred to as upstream and this was also brought up in the reading. A person’s social and economic environment is the largest determinant of their health.
The second reading focuses specifically on advocacy and what that really is. The reading defines advocacy as, “a catch-all word for the set of skills used to create a shift in public opinion and mobilize the necessary resources and forces to support an issue, policy, or constituencyâ€. Advocacy is all about empowering people to have their voice heard so changes can happen on an institutional level. The process of advocacy and media advocacy aimed at public health issues follows very similar steps as health communication campaigns as a whole that we have previously read about. They need to be based in credible data, have specific and attainable goals set, and have a clear channel for giving the message. Advocacy is the upstream approach in which the root problems/population health determinants can be addressed.
The first reading gave an overview of public health and media advocacy. This reading reminded me of my current supervisor’s saying that she decided to go in the public health field because she wanted to save the world. Like the Adam and Eve story and its three perceptive, in public health all three professions matter equally and work interdependently. The idea that advocacy turns disease from an individual problem to a communal problem is major especially in a market driven society such as the US. For this reason, I believe advocacy works against market justice. My strong belief in this stems from my sociological background from my undergrad major. This reading also talked about blaming the victim. Although, society as a whole has a lot of exceptionalism beliefs, there has been some progress. For example, the emergency room not being able to turn away those in emergency situation regardless of their financial status.
The second reading focused heavily on advocacy. While reading this section, I was constantly thinking about social justice work because of the planning process and assessment aspect but realized that public health advocacy is much more respected than social justice work but they go hand in hand; society just has a much different view because there is science that usually backs up public health.
I was drawn in quickly to the first reading, “Public Health and Media Advocacy,” when I read this sentence on page 4: “Public health is essentially political.” I have never thought of public health in this way before, and I think it is an incredibly interesting way to frame public health work. As discussed in the article, it may seem like most health issues are caused by biology or individual choices; however, in reality, the issues are caused by underlying social and economic conditions. Because the government has direct influence on the social and economic conditions, public health is inextricable from politics. It is often difficult for me to understand why individuals in power would support policies and programs that contribute to the worsening of peoples health. This was an important reminder that many of these actions are politically motivated. Instead of shying away from becoming political, I should embrace this as a way to make a wide impact.
The discussion about market justice reminded me of posts that I see online frequently asking people to donate money for medical expenses. A simple search on GoFundMe turns up thousands of medicine-related fundraisers. When a community rallies together to help someone with these expenses, it is praised and widely publicized. However, it is much less frequently that I see people asking the question, “Why do those in need have to depend on the welfare of individuals?”
The second reading, “The Advocacy Connection,” gave more specific information about how public health advocacy can be conducted. I appreciated the recognition that often advocacy is an uphill battle. For example, advocacy can be threatening to corporate interests, and public health organizations often do not have the monetary resources to match those of the corporations. I would be interested to learn more about coalitions like the Milwaukee Coalition Against Drug and Alcohol Abuse and how they are able to attract such large amounts of high-quality participation. I think that one of the most useful skills I will need in my future endeavors is learning to organize and motivate individuals to participate in community health education programs, so I enjoyed reading about such a successful example.
This week’s readings discussed strategic health communication. Both readings provide a lot of stories and anecdotes about how to strategically talk about health with others. The first chapter goes into media advocacy, and how it lets the story be told from a public health perspective. One thing that really stood out in this reading was the concept of victim-blaming, and how it can be a consequence of media advocacy. If it is done incorrectly, media advocacy can lead to overanalysis of a problem and may cause one to place blame on an individual, instead of helping them.
The concept of advocacy continues in the second chapter. Advocacy is described as a way to support others. The story about the person drowning was a great example of how certain methods may seem helpful, but may not fit the needs of the situation. The authors talk about identifying “experts” in the community, and how it is important to give these individuals an “authentic voice”. Experts can range from a wide variety of people, but when working in public health, the experts are usually members of the community. The idea of an “authentic voice” helps to humanize the issue at hand. This made me think about the campaign we saw last week during class. The initiatives used real stories of people who suffered from opioid addiction. This tactic was used to draw attention to the issue. The chapter continues by saying that this method should be used with caution. Who we define as “experts” can have a significant impact. Identifying some individuals over others can potentially be stereotypical and limiting. The authors encourage us to be mindful of this and to incorporate these practices into our advocacy work.
I’ve always been a social justice advocate and when working within Public Health I believe it is crucial to support social justice. I think social justice and health equity (what we should try to achieve) go hand in hand because it is the fairest and many deep-rooted issues arise from socioeconomic status. However, this was the first time I came across the term market justice which is based on “key assumptions that largely determine the acceptable range of approaches to public health problems.†(pg 6). It is about thinking of problems as an individual and a person being able to have control over one’s life and circumstances. For example, “market justice suggests that benefits such as health care, adequate housing, nutrition, and sustainable employment are rewards for individual effort (on a level of the playing field), rather than goods and services that society has an obligation to provide.†(pg 8). I strongly disagree with this because people don’t have full control over their lives and the situations and circumstances that they face. Everyone does not start on an equal playing field.
Working as a Program Coordinator at Boston Children’s Hospital, I witnessed that not everyone gets the same quality of care mainly due to their insurance but also secondary factors such as race and education level of parent/guardian. Many people are turned away due to the poor quality of coverage their insurance provides so I don’t think the U.S. Health Care System is doing its best in terms of caring for their people. Health care is not a right here in the states but rather a privilege. Moving on to the second reading which was mainly about health advocacy, it is our job especially as community health educators to advocate the rights for our communities; especially vulnerable populations. The reading generalizes the term of advocacy but advocacy can happen on all levels and sometimes the grassroots level can be the most effective and most impactful.