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The Bigger Picture

December 9, 2013

Recently the IOM Roundtable on Health Literacy convened a workshop titled Implications of Health Literacy for Public Health, which included a presentation on a San Francisco program in which youth speak to youth about diabetes. The Bigger Picture Campaign is an anti-diabetes multimedia project; a collaboration between the UCSF Center for Vulnerable Populations and Youth Speaks, the leading nonprofit presenter of spoken-word performance, education, and youth development programs in the country.bigger-picture-logo

The campaign is designed to raise awareness about the social and environmental factors that have led to the explosive rise of type-2 diabetes in California. Its health literacy innovations include peer-to-peer communication, high-quality video public service announcements, eloquence and poetry, and frank messages about the social determinants of health. Check it out here, and if you have time to watch only one of the public service announcements, make it “Health Justice Manifesto,” a compelling wakeup call. The lack of healthy food choices and opportunities for physical activity in poor communities are key messages.

In addition to producing 11 public service announcements that are available on the Web, there have been 15 school assemblies, and the development of an educators’ toolkit, a free resource for educators and students to learn more about type 2 diabetes.

The plan is to take the program statewide in California, starting with such high priority areas (with large underserved communities) as Stockton, Richmond, and the Inland Empire, and eventually introduce it across the country. The presentations are potent, but to reach a wide audience, school administrators, nurses, wellness coordinators, and teachers must ensure that students have the opportunity to see and hear the campaign messages.

Last week the IOM conducted another workshop, this one for the Roundtable on Population Health Improvement and the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities. The daylong meeting examined the history and sociology of social change movements, with an aim to identify key elements of a theoretical and practical framework for movement building. This fundamentally political agenda is consistent with the San Francisco awareness program that also wants to change people’s thinking and priorities. And both workshops fit within the contextual bigger picture of social determinants of health.

Whether past social movements have relevant lessons to current population health crises or if information, no matter how it is packaged and delivered, is sufficient to mobilize effective action against broad social determinants of illness are issues for debate. Richard Carmona, the 17th Surgeon General of the U.S., describes the ‘trauma of politics’ in this country and issues a stern warning. “As Surgeon General I also realized that most of the disease and economic burden we incurred as a nation were preventable, but that the trauma of politics was a confounding variable that prevented us from addressing many of the issues in a timely, nonpartisan, evidence-based, scientifically driven manner.”

Can we acknowledge this part of the bigger picture, and if so do anything about it? Eventually. Maybe.

— Michael Lytton, AJPM Blog Editor

Further Reading in AJPM:

Carmona R. The Trauma of Politics: A Surgeon General’s Perspective. Am J Prev Med 2013;45(6):742–4.

Moulton AD, Albright AL, Gregg EW, Goodman RA. Law, Public Health, and the Diabetes Epidemic. Am J Prev Med 2013;45(4):486–93.

Ramirez AG, Ayala GX. Addressing Latino Childhood Obesity Through Research and Policy: Findings from the Salud America! Experience. Am J Prev Med 2013;44(3 Suppl):S173–296.

Kraak VI, Story , Wartella EA. Government and School Progress to Promote a Healthful Diet to American Children and Adolescents: A Comprehensive Review of the Available Evidence. AM J Prev Med 2012;42(3):250–262.

Kraak VI, Story M, Wartella EA, Ginter J. Industry Progress to Market a Healthful Diet to American Children and Adolescents. Am J Prev Med 2011;41(3):322–33.

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