Words Matter, but So Do Social Determinants of Health

As a content strategist, I believe words matter. The words doctors use can help or harm, and writing for the appropriate health literacy impacts a person’s ability to make healthy choices.

But sometimes I need a reminder: it’s not enough. Social Determinants of Health add barriers for people to get care or care for themselves. While words do matter, words alone can’t solve issues with access to care.

What is “access”?

“I want to eat squash and zucchini and all that, […] But, I don’t know how to cook it.”

Racial and Ethnic Disparities in Health — and How to Fix Them

When it comes to health, “access” means someone’s ability to get to a doctor, or get to a place they can safely and enjoyably exercise, or get to food. Issues with access may include physical, financial, or even social access.

Physical access:

• It’s too far away
• No car, and no public transportation
• The place is in a dangerous neighborhood
• The person lives in a dangerous neighborhood, and so ideas like “go for a walk” are not feasible

Financial access:

• No health insurance, or insurance with high copays and deductibles
• Healthy foods are too expensive
• Getting an exercise bike, elliptical, or other equipment isn’t affordable

Social access:

• No one around the person eats or cooks like that, so they have no one to learn from
• Other people will judge the person for going to the doctor
• Lack of trust in the doctor or health system

Particularly for people of color, access issues are significant. This is a huge part of what causes racial and ethnic disparities in health. And that’s why many of the “solutions” people discuss focus on what The Atlantic calls “bigger answers”:

Decrease child poverty. Invest more in education. Provide jobs that pay a living wage. He worries about a growing body of research showing that the stresses of living in poverty — the many ways it undermines families and communities — damage children’s brains and their long-term health.

Racial and Ethnic Disparities in Health — and How to Fix Them

Why do words matter?

If words can’t solve access issues, why do words matter? Obviously words can’t decrease poverty, or provide a higher living wage.

But there are some things that words can do. For example, Dr. Lisa Fitzpatrick uses her words to build trust between patients and providers.

 I started a video series called “Dr. Lisa on the Street,” focused on engaging people in conversations to connect them with health information, but also because I’m trying to build a brand around providing trusted health information that bridges the community back to the health system.”

The Public Health Value of Speaking Plainly

Words work in parallel with bigger answers. Public health speaks of this as the “River Story,” an analogy showing three ways to address health. In this story, three people come across a river with children floating toward a waterfall. The first person jumps in to start pulling children out. The second person begins to build a damn. The third person starts running upstream to figure out why the children are in the river in the first place.

In this example, the person pulling children out is comparable to an ER doctor speaking plainly to patients; and the second is a digital content strategist, creating farther-reaching apps and websites that communicate well and help point people to affordable or accessible healthy choices. The third is focused on the bigger answers.

Words and bigger answers

While each of us must individually choose to be a doctor, a content strategist, or a policy creator, as a community we need all three. We need healthy words. And as a community we need to look to bigger answers as well. So let’s not discount our words. But remember – they’re only a part of the bigger problem.