Trump autism announcement highlights the need for better health literacy

In the wake of the Trump / Kennedy autism press conference, how can health literacy help young people find accurate information about healthcare, pain medication, and vaccines?

The long awaited Trump autism press conference in the USA revealed a disjointed, confusing health message along with distressing assertions about mothers, health, an autism 'epidemic', pain medication and mothering, along with suggestions about everything from vaccine schedules, mercury and 'toughing it out', through to poorly recited statistics and anecdotes. It really was a press conference with everything! As educators and professionals working with families and young people, how can we utilise health literacy as a tool to support our students in the face of half truths, unsupported claims or emotive calls from the President to end the use of Tylenol in pregnancy?

Health literacy is a great skill to teach young people, so they can find accurate, up to date and relevant health care information to help them live their best lives. The autism press conference which linked autism with pain reliever Tylenol was a somewhat disturbing example of how information, no matter how factual, can get a hold on the community if it is repeated enough. Health literacy is one skill in the toolkit of young people which can help them navigate conflicting and potentially dangerous information as they move into adulthood.

Health literacy skills help young people find accurate health information

Does ice cream in summer cause crime?

One of the helpful skills to teach is to understand the difference between a causal relationship and an association. Just because two things happen at the same time, does not mean that one causes the other. A handy example is the relationship between crime and ice cream eating. Although both things might increase during summer when the weather is warmer, this does not mean that ice cream eating is related to crime. In fact there are other factors at play which happen at the same time as ice cream eating - the weather, more people out and about, changes in behaviour in summer compared to other seasons. Just because more ice creams are eaten in summer and there is more crime in summer does not mean one causes the other.

Finding accuracy in a sea of autism misinformation

Another helpful health literacy topic is how scientists study medicines and health treatments. If we want to know anything in science, we begin with small studies and then move to much larger groups of people over time. Scientists check out whether medicines and treatments are safe and effective, and whether there are risks that need to be balanced against potential benefits. They also try to test in ways which remove the effect of other things that might cloud the results - like the ice cream and crime example. The third important topic to cover in health literacy is looking for reliable, repeatable and sound sources of health information. Often this means pointing young people towards government sources of health information, their local doctor or pharmacist, a health practitioner or health worker in their community. These are usually places where young people can go for information that is given by someone who knows the topic, understands how to explain it in a meaningful way and can suggest further help if it might be needed.

It is also really helpful to talk about facts, information and data in ways which are clear and direct. This doesn’t mean simply repeating an idea in a short simple sentence (like ‘Don’t take Tylenol’). Rather, it means taking the emotion out of the information, so that what is left is factual and not biased. Emotional language in healthcare becomes problematic because it can lead people to respond emotionally, rather than relying on facts. Emotional language works particularly well for situations where there are strongly held views; autism and vaccines being a great case in point.

Presenting health information clearly and without emotion or bias is vital

Health communication about medicine and autism

When it comes to Donald Trump and Robert F Kennedy Jnr and yesterday's press conference, the need for good health literacy was abundantly clear. Health literacy also just became a lot more challenging. It should be a reasonable assumption that the President of the United States and the Secretary of the Department of Health and Human Services would clearly and accurately reflect the best science available in an autism press conference. In fact, the conference wandered back and forth across some familiar Kennedy favourites, including vaccines, interspersed with assertions from Trump about the importance of women not taking Tylenol in pregnancy. It lingered for a while on the topic of finding a 'cause' for autism, and focused heavily on small studies and anecdotal evidence (such as Trump's story about a woman he knew who had a child who he believed had been harmed by a vaccine, and Kennedy’s assertion that he had never seen an older person with profound autism). The inference in both these anecdotes was that it was reasonable to assume that because you can find an example of something, it therefore can be applied to the community as a whole. In Trump’s case, because he could identify a person he knew who had a particular experience with her child, that could therefore be applied to all women and all children. In the case of Kennedy, he seemed to believe that because he had not seen something with his own eyes, it therefore did not exist.

Relying heavily on emotive language, Trump worked hard to deliver repeatable sound bites; 'Taking Tylenol is not good,' 'When you're pregnant, don't take Tylenol,' 'Fight like hell not to take it,' and 'Don't give your baby Tylenol after the baby is born, every time the baby gets a shot...' He wandered from one topic to another, spouting varying autism rates which seemed to range from one in 10 to one in 32, depending on where he was up to in his speech. He touched on Tylenol to drug companies, to the price of drugs in the USA, to the MMR vaccine, then back again to his preferred assertion that mothers should simply ‘tough it out’ during pregnancy rather than use Tylenol.

Sound bites are not a replacement for solid health information delivered by a professional

The press conference also heard from a mother who had children with autism and levelled the autism squarely on vaccines. Interestingly, the question time at the end of the conference strayed into new topics such as whether Cuba has autism despite not using Tylenol (it isn’t widely available and Cuban autism rates are lower than in the USA, likely due to differences in diagnosis and access to healthcare), and why the Amish community has autism or ADHD (some research suggests slightly lower rates than the community as a whole, but potentially this is related more to reporting and interaction with medical professionals than a true difference). Essentially the press conference was a great example of how not to deliver health communication – disjointed, wandering from one topic to another, lots of anecdotal information and varying connections to fact. It was confused, confusing and strayed off topic repeatedly.

Health literacy for the future

Going forward, health literacy will become ever more vital. Young people will need to rely on core literacy skills like understanding association or causation, knowing how medicines and treatments are tested to show they are safe and effective, and how to find health information which is reliable and relevant for their own situation. Health literacy will also need to support young people in understanding bias and filtering information to remove emotion so that what remains is clear, direct fact.