Where is Health Learned?

By: Sean Kloppenburg

This post is about my pursuit to get preventative health tests, or labs as they are sometimes called, to measure certain things about my health status. I also will relate this to recent health-statistics I have looked up. I hope you find the reading helpful. Enjoy!

It has been quite a journey to acquire these "preventative labs". These labs are used to assess current health via a variety of measurements, usually of things in the blood. In particular I am interested in the CRP test (c-reactive protein test, learn about it here.). I want to know if my endothelium are inflamed. I know how dangerous cardiovascular disease (CVD) is and I suspect that my sugar intake overtime has affected my general inflammation. Hence I am looking into the CRP test. Especially through the long term lens, sugar, is one of the worst culprits on health. With the grand total of ~56 different names for sugar, it is easy to ingest at repetitive high levels. This can cause serious damage overtime (3). And let me tell you, "high levels" of sugar intake are super easy to achieve. The problem of high sugar intake is systemic across all health. Why are we so sensitive to sugar? Because our bodies evolved with the expectation to never get it - hence it tastes so delicious. Another health motto to remember: the body loves anything that is rare in nature. Think sugar, fat, salt. When your used to getting sugar doses from processed foods there is no way you will be sensitive enough to enjoy the sugar levels of, say, an apple. So the process of becoming sugar sensitive again is generally done by avoiding it. With enough time your expectations and taste buds will have adjusted. You might be surprised to experience what sugar does to you, after you have adjusted. Now, does sugar act alone in affecting your health? Of course not. That is not how the universe works, nor is it how health works. There is always a meeting of multiple streams. Here in this blog, I will be focusing on sugar.

One of the biggest forces sugar influences is inflammation. Chronic inflammation is so debilitating in the worst of ways because it is silent of warnings (1). If you were touched by the The Complexity of Health post, you will not only intellectually understand, but feel the relevance of how inflammation can impact a plethora of preventable diseases. Including blood pressure and arthritis. Think, on top of all the other reasons for blood pressure to rise, and now add that the endothelial cells lining your arteries are inflamed.

So, with all that in mind. As a health professional I should "walk the talk" and get preventative labs on my health status. It is one of the few ways to assess how your long-term behavior has affected your health. Remembering your health behavior is not enough to know exactly what has happened to your health, especially over the course of months and years. However, your body remembers every gram of sugar you put in.

Why does this blog title include the phrase health literacy? Imagine if I was not a continuous training health professional. Without the six plus years in the field experience and four years of study, would I  1) have known about a specific test, such as CRP? 2) have made it through the challenges that I am now going through to simply get a few preventative labs done?

Pictured below is a screen shot of my Apple note pad that I used to jot down these challenges.

These notes where written over the last several months as of May 15th 2016.

All those bullet points are quick-notes. I took this screen shot to show all the steps it has taken me to get in touch with my doctors office. The beginning was simple. What tests will they run? And will medicaid cover it? That is it. In the end it has taken three months. This is where my passion for health education is invigorated. I had moments where I thought, "...to hell with this, I am "healthy", why bother." Imagine if I wasn't willing to deal with the barriers? Imagine if I didn't know what the health terminology was? Most people would be completely deterred at the bullet point: "medicaid might not cover ~ $1,000". This is one of the reasons I was interested in health policy and management, because the barriers involved to get preventative labs are absolutely insane. And I have it easy compared to some. I have internet access, a cell phone, a job, and access to the labs.

Is this the most challenging thing people undergo to achieve proper health promotion? Most definitely not. What I am stressing here is that planning healthy behavior is very fragile. It is like a thin layer of ice on a moving creek. One wrong jolt, and your plans will be swept away by emotions, tacit judgements, and perceived justifications. I recently took the test to become a Certified Health Education Specialist, and trust me, it is very clear that one barrier is enough to shake even the most determined. I am sure you can think of people who are both determined, yet they seem to never quite get there. How does one overcome, or bypass potential barriers? Many behavior change theories use the term "self-efficacy", which basically means self-confidence. It is the measure to which an individual will overcome challenges to perform the health behavior. The only way this self-confidence is reinforced is through success. Tied to personal experience, success comes through personal relevance.

So, this leaves the obvious question, what does one do? How does one navigate the world of health promotion with so many barriers? And where do we learn about health? One must find the relevant reasons to exert yourself with self-efficacy. That is it. Period. You're not dumb, inept, or lazy when you don't stop yourself from consuming a Wendy's shake. Or when you choose to watch TV instead of going for a run. You simply haven't found a way to relate the health wisdom you already know to your personal experience. This is exactly why people end up waiting till a health problem arrives. Because it is not relevant, until it arrives, to their personal experience. Equally important to recognize is that health is dynamic and different for everyone. For example, rest and caring for one's environment is also health, yet also personal. Challenges also extend to the places that you live in. Does your city, neighborhood, or home make it easy or difficult to perform healthy activities? What does the culture expect of you?

Where is health learned then? It is amazing the differences between those with a high school education versus those with a college education and how they pursue health information. Those with a high school education rarely go online to find health information, and college educated are just the opposite (2). This is why I have hoped that many will take my two surveys so I can assess who my audience is. According to the PewResearch Center, almost no one reached out to an allied health professional for health information when they had a serious health issue (2). This makes sense. Why go to a Personal Trainer when you could go to a doctor in a situation that involves a serious health issue? What I would like to know is where do people go for preventative health? Because, based on what I have seen, preventable diseases are a serious health problem. Moreover, in a given life span, where and why do people learn about health? In an effort to answer these questions I scanned lots of data and eventually emailed the Centers for Disease Control (CDC). Here were my exact words:

Hello,

I am searching for a study, report, maybe a survey. A collection of data answering the question: Where do people learn about health? As it is a large question (doesn't include many geo-demographical factors) I am open to what I find. However, I am interested, specifically, in where in a given life-span does an individual mainly learn about health. For example, is it only in K-12 schooling? I have read several data sets on where different demographics go to learn about health (for example the internet), but I am interested in where (generally) they learned about it originally.

Do you know of any survey or study that covered this question proximally or directly? I am imagining something along the line of "Where do you learn about your health?".

Thanks for the time.

S

Sadly they did not have any health statistics on that specific question. Sad because it is mind boggling that we are not assessing where health is learned. True, when analyzing populations, one must make your language very specific. In the end there was zero information on any survey or data set that  I saw. Obviously we all know our personal stories, and from what I have seen in Boulder Valley School District, health education is not simple. Stressed for time teachers will focus on sex-ed before anything else. That is needed, but when it comes to preventing non-communicable diseases, like CVD, I wish there was more time to educate all of us.