Health communications expert gives US a ‘C’ for pandemic performance


As reported by the United States recording levels new cases of COVID-19, the health communications industry is facing increased stress. Recently, the Centers for Disease Control and Prevention faced critical for its communication on the pandemic, in particular the decision to shorten the period of isolation for people who tested positive for coronavirus.

“Marketplace” host Kai Ryssdal spoke with Cynthia Baur about the health literacy and health communication practices we’ve seen during the pandemic. Baur is director of the Horowitz Center for Health Literacy at the University of Maryland School of Public Health and previously worked at the CDC for 10 years. The following is an edited transcript of their conversation.

Kai Rysdal: Is health literacy usually that hard? It just seems to me that we are going in circles.

Cynthia Baur: In fact, it’s quite difficult because human communication is quite difficult. There’s a lot of misunderstandings and confusion that lingers, and COVID has just kind of been Exhibit A of the difficulty.

Rysdal: Well I was just going to say that you start a pandemic, and everyone’s awareness and agitation increases by a factor of 10. Is there an easy way out of the communications mess in which we are currently with public health, do you think?

Baur: There is no easy path, but there is a way out. And part of that is sort of going back to the basics of communication, which is explaining things very clearly and simply without jargon. And do it as often as possible.

Rysdal: I wonder if that’s part of the problem though, isn’t it? Because health literacy and health communication isn’t standard brand communication, is it? Advertising is about hitting people a million times. And now it seems to me that there is almost too much information, some of it contradictory, which is a bit tiring for the public consuming health communications.

Baur: Well, that’s a really interesting point because there’s a lot of information out there. But there is a lot of information that intentionally or perhaps unintentionally disrupts the information environment. So, for example, there are a lot of people who decided they wanted to try to interpret what federal agencies like CDC and [the Food and Drug Administration] say, and in many ways it confuses as much as it helps.

Rysdal: Yeah. You have been at the CDC for many years. And I’m just wondering, based on your experience and your ideas, do you imagine the communications professionals there, because government agencies have communications professionals just like brands and businesses, imagine you think they’re tearing their hair out?

Baur: I imagine they are quite tired. And I imagine they’re quite frustrated that things haven’t improved. I know they are very dedicated and really try to do their best. But it is a rather complicated situation. And, you know, unfortunately, some of the early communications about the virus really put things on a pretty rough path. So they have lots and lots of ground to cover and make up for.

Rysdal: Tell me your perspective as a communications professional and as a woman who has been doing health literacy communications all her life. When you look at what the CDC and others have done, what’s going on inside? How is this message broadcast and then scrambled?

Baur: Well, it’s quite a complicated process. Some people have the designated role of being a health communicator or health educator. And they work as a team, don’t they? So they’re working with other subject matter experts on whatever the issue is, in this case, COVID. Ideally, they work together to write this information, but they still have to go up a chain through a clearance process. And you know, the CDC might not be the only agency involved in its creation. Other federal agencies could be involved, external partners, for example state health departments. So it’s a pretty complicated multi-step process. And in a way, we really want our federal agencies to think about all of these different factors before releasing information that could change, not just public policy, but also people’s individual behaviors.

Rysdal: On the theory that you’re going to be asked to participate in any post-mortem for health communication during this pandemic, give me a letter grade. How are we doing so far?

Baur: Uh, I would say a “C”. I think we haven’t completely failed. I mean, there’s a lot of research that shows people have learned certain things about infectious diseases and what public health does and how to protect themselves. But unfortunately, we’re really far from where we could have been if the communication had worked, you know, like it should have from the start. So I would say it’s not a complete failure yet, but I think we could have done so much better along the way.


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