Making the World More Health Literate

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I think one of the biggest challenges in global health is, how people understand what health is, and I call it health literacy, and not only do I call that, but there is a definition of health literacy that's part of both United Nations activities in terms of global work, but United States has a national action plan on health literacy.

And the reason is that, many people don't understand the basic skills, or don't have the abilities that are necessary to manage their health, and the system is so complex that people don't pay attention or the system doesn't give information to them, and ways that they can use them. Health has been thought of a basic human right, but it's not just in pursuit of health, it's in pursuit of happiness, and longevity, and having some values and virtues.

I think more now people realize that health, not only because it constitutes almost 70% of the GDP in the United States, but really around the world it touches everybody dealing. You know what keeps me up at night is that, the world is not paying attention to chronic disease. It's estimated 45 trillion dollars will be spent on chronic disease by 2020, and we will not be able to address it as people get worse, if we don't start to prevent it.

Can we come up with something that's simple enough, take seven numbers, and put them into one composite that people can pay attention to. And we've done that recently with what I call a Digital Health Scorecard of looking at people's cholesterol, blood pressure, blood sugar, BMI, alcohol use, exercise, and tobacco.

If you take those 7 or 75% of the risk factors for chronic disease, roll them in the one number and get people to move on that, we'll begin to at least show some way that people can empower themselves, and a system that can move toward prevention rather than treatment. Infectious disease is probably one of them that I think we have to worry about in the United States, not just multi-drug resistant, tuberculosis, or extremely drug-resistant tuberculosis, whatever that threats could be, but we need to be able to have surveillance at a level that we know where both, the bacteria, viruses, microbes maybe, and have a system in place.

We're going to improve the global health environment, international health regulations, and so forth, so that we're able to one, identify, sometimes a question and other times treat or prevent any of these outbreaks. I'm seeing they're having an effect, global social media on vaccines, right now, Washington State, there's places in Washington State that they have the same poor coverage as Northern Nigeria where 30% of people are opting out.

Similarly, you have vaccines that have an incredible amount of hesitancy, people in United States not even wanting to give their children the whole immunization schedule because they have heard of some pieces, not evidence based for those metasol, links with autism, or other pieces. I also see the fact that we think we can have an HIV vaccine in five years or ten year, but people are willing to take vaccines, it doesn't matter how great that vaccine is?

I think at the end of the day, while technology is an enabler, technology is not the only answer. We're still trying to eradicate disease with vaccine that are 17th century inventions. We're probably have newer vaccines, therapeutic vaccines, vaccines when somebody has something. There will be other ways that we're looking at imunology and other areas.

I think we need to come out with the basic numbers that make difference to large population where we then can predict and prevent based upon those numbers. I don't think we need to have 100 things that we need to know and do. I think we need to have 10 simple ones that give us about 90-95% certainty.