HLOL Podcast Transcripts

Health Literacy

Working with Journalists to Communicate about Health (HLOL #149)

Helen Osborne: Welcome to Health Literacy Out Loud. I’m Helen Osborne, President of Health Literacy Consulting, founder of Health Literacy Month and your host of Health Literacy Out Loud.

In these podcasts, you get to listen in on conversations about health literacy with some pretty amazing people.

Today, I’m talking with Beth Daley, who is a Senior Investigative Reporter and Senior Trainer at the New England Center for Investigative Reporting, or NECIR, which is a nonprofit based at Boston University and the public television and radio station WGBH.

Prior to NECIR, Beth was a reporter for many years at The Boston Globe, focusing primarily on science and the environment. She has won numerous national journalism awards, including the Knight Journalism Fellowship and being named a Pulitzer Prize finalist.

I’ve been Beth’s fan for many years, reading her writing both in the Globe and now her investigative reports. I am delighted she agreed to be a guest on Health Literacy Out Loud.

Welcome, Beth.

Beth Daley: Thank you so much for having me.

Helen Osborne: Wow, you wear so many hats and you’ve been doing this so long. Our listeners are likely not journalists. Start us at the beginning. What does a journalist do and how can it encompass so many different aspects?

Beth Daley: Journalism is not just one thing. I’ve learned this over the years. What people are most familiar with is daily journalism. You pick up The Boston Globe or The New York Times or read it online and it’s basically what happened yesterday.

Reporters are under a lot of pressure to turn around stories very quickly. They often look at press releases to rewrite stories and quote some people, but sometimes they have to write a story in an hour or two.

Helen Osborne: Oh my goodness. I used to be a columnist. I couldn’t do anything in an hour.

Beth Daley: I started out at a little paper as a reporter where every day I had to write about two to three stories. It was intense.

Helen Osborne: Oh my goodness. In the newspaper, what we’re reading is really what happened very recently.

Beth Daley: For the bulk of it. Then in every newspaper, at least hopefully, there will be a few stories called enterprise stories. Enterprise stories are not something you do in two hours. It might take a day or it might take a week or even two. These are more in-depth stories about a subject.

Let’s say you’re writing about windmills or a wind farm being built. You may not just write about that one wind farm being built, but you might put it in context and compare it to other places. It’s something that goes a little deeper than just quick reporting.

Helen Osborne: You call that an enterprise story? Is that what I, as a reader, would call it? I’m not familiar with that term used that way.

Beth Daley: It’s mostly used in journalism. It’s basically a story that is an idea that’s original and you go deeper into a subject. Enterprise reporting might be saying, “Did you know that under Nantucket Sound is a sunken forest, and there are possible remains of Native American artifacts there?”

Helen Osborne: It’s the story behind the story a little bit.

Beth Daley: Yes, or a little different angle or something on a topic of the day. The last part or what I mostly do now is called investigative reporting. This often takes much longer. I could spend a year on stories.

Helen Osborne: Oh my goodness.

Beth Daley: It goes very deep into a subject, meaning no longer can you just simply take people’s word and quote what they’re saying. You can certainly do that, but every single piece of information that you try to find, you have to get to the primary source. You have to make sure it’s actually true.

Helen Osborne: Beth, what certainly comes to mind is what happened in The Boston Globe years ago and now is in a movie “Spotlight” about the Catholic Church and sex abuse in there. Is that investigative reporting?

Beth Daley: Oh, yes. That’s fantastic and the best of the best investigative reporting. They took a subject that frankly everyone knew about. It had been written about. Sexual abuse by priests was known. There were a couple of cases here and there.

The Globe and, at the time, Marty Baron, the editor, made a decision that this was going to be an important story that we had to get to the bottom of.

We had to not just write about one person. We had to, like an onion, peel back the layers and understand how it all started and who was in control of it. They forged a very brave battle against the Catholic Church, which they ultimately defeated.

Helen Osborne: In the movie, I learned so much about the behind-the-scenes of journalism. I’m assuming it’s mostly true. Is that what you do? Your focus is science, health and the environment. Is that correct?

Beth Daley: Yes. The “Spotlight” team did something that took many people, more than just the people in the movie, and it took a year at least, if not more.

I do a version of that. I mostly report on genetics and conflict of interest. I’m very interested in basically how we’re getting information about this new world of genomics, who’s giving us that information and if they’re being biased in some way because they have financial relationships with companies.

That’s something I look into and it’s quite difficult to research because this area is very unregulated by the federal government.

Helen Osborne: I would think not everybody really wants to hear that Beth Daley is on the phone.

Beth Daley: We always talk about our day because we call and I say, “I’m calling from The New England Center for Investigative Reporting,” and everyone just hangs up on me all the time because it’s a very intimidating name.

I try to put people at ease because I’m really just trying to get at the truth. My goal is to protect the public and inform the public.

I also write about the environment, so I do a lot on sea level rise and looking very deeply into how much money is going to protect really a very small number of homes along the coast.

Helen Osborne: Wow, such timely issues that you’re focusing on.

Beth, our listeners are all involved in health somehow and communicating about health. The issues you’re talking about affect all of us, but you also talked about conflict of interest. All those issues touch on what we do. What can we, who are non-journalists, get from this other than a deep appreciation of your writing?

Beth Daley: I think people who read newspapers or read online need to be intelligent consumers and understand what they’re getting, because like anything else, journalism is a business. Our goal is to get information out to the public. That’s our first goal. How that information actually gets to you is a really interesting backstory.

Many science stories I wrote when I was a daily news reporter were based on, frankly, press releases of studies that were coming out in academic journals or research journals.

What happens is there’s a finding and then an academic journal often has someone write a press release about that. Reporters often, because they’re pressed for time, will look at that press release and write a story off of that and quote a few other people if they have time. That is something people should be aware of.

You know it intuitively when you see things like “Red wine is good for you. No, it’s not. Coffee is good for you. No, it’s not.” It’s always based from these new studies coming out and it’s just a progression of science that you’re seeing. No story is definitive.

Helen Osborne: Those can be based on press releases, so be discerning. We should have that question mark when we read those, saying, “Really?”

Beth Daley: Everyone’s job in life and business is to make their work look and sound really good. That’s just the way it is. Scientists or academic institutions are no different. It’s not the individual’s fault or anything, but the forces are always conspired to make things sound more sensational than they potentially are.

Helen Osborne: Also, perhaps, more definitive.

What I’m finding in communicating this, whether it’s to patients, to the public or people I know and care about, is that it’s conflicting information. Is coffee good for you? Is wine good for you? Yes or no? What about this medication or that thing? It’s very confusing.

Other than putting on our hat of skepticism, how else can we be those good consumers of health information?

Beth Daley: It’s hard, because there is so much health information coming at you these days. It’s like every five minutes you have a new piece of information about this drug or that drug or do this or don’t do that.

The best advice I can give is to take the long view. First, understand what’s been written before about the subject before you change your lifestyle or habits or check with your doctor.

The second thing is, in addition to taking the long view, really question where the information is coming from. Is it coming from a peer review, which means independent scientists have looked at the study or the data?

These can take you a day to research, but they can take you just a few minutes too. You want to be really going to understand that this is coming from reputable people.

Before you change anything, do a Google search and see what the history says. With science and medicine, it’s not like there’s a discovery and everything stops. Science is a progression of hypotheses and ideas that get disputed and refuted. There’s really no end to it, so you just have to understand there’s a long trail of information behind that one story you see.

Helen Osborne: I like the way you described that as a progression of hypotheses. It’s like a stairway building.

Our role in many cases for many of our listeners is not only being discerning ourselves about that information, but then communicating it outward.

We take what’s already been distilled by journalists and then we have to understand it and get that word out there. It’s being translated a couple of times like one of those translating softwares out there. The message gets muddied after a few times.

That’s a big job for you as a writer and for me as the reader and then the communicator. Do you have any tips for us that way?

Beth Daley: Health literacy is a super important topic and it’s unfortunate that things are getting more complicated in health information.

Helen Osborne: They are.

Beth Daley: People don’t understand and doctors don’t understand some very basic concepts. I don’t want to say this is basic, but it is basic. It’s the difference between a screening test, which basically tells you the risk of potentially having a disease, and a diagnostic test, which tells you if you have it.

Over and over again, doctors and patients confuse the two and believe that a screening test actually diagnoses a condition. That’s unfortunate.

Helen Osborne: Even doctors get that wrong?

Beth Daley: Yes, especially in this genetic field. Genetics are becoming a major part of our healthcare and will become a gigantic part of it fairly soon.

It’s because a lot of this is unregulated, so companies can say what they want in advertising and marketing. They’re not regulated by the FDA in many cases, so they might say, “Our test is diagnostic. We’re 99% accurate.” They’re being misleading. They’re not telling the public in clear language, “This just tells you the possibility of a problem. Do not act on it.”

Also, many doctors are educated by salespeople from these companies. It’s not like doctors are out looking at new research and then trying to find a company to offer a new test or a new product for it.

Every day, they get calls from salespeople who want to bend their ear or take them out to lunch to pitch them a product, so they’re also getting biased information and often they don’t vet it.

Helen Osborne: Beth, I’m exhausted listening to you. I was just working on a project where I was rewriting information in plain language and it was about screening tests. I was trying to explain to the client that people don’t understand even what a screening test is and how that’s different from diagnostic.

She was talking about the more traditional screening test that we’ve been doing. I hadn’t even thought about that genomic kind of test where you learn about all the diseases you might ever get. You’re taking us light years from there. We’ve got a huge job to do in health literacy.

Beth Daley: Exactly. You have a steep road and so do I. I wish people would understand it.

Helen Osborne: You have to understand it, and then we have to understand it from you, look at our other sources too and then communicate it. I’m glad you’re doing what you’re doing and I’m glad so many folks are doing the health literacy part and putting it all together.

As far as that intersection between the two of us, I know you and I have had some back and forths in other instances. I tried pitching you a story. I thought it would be great if you focused on informed consent and how it’s not always informed and it’s not always consent. But it didn’t quite make the top of your pile right away. Maybe it will someday.

That’s just an example. Can you just talk a little bit about, if we know something we’d like to bring more attention to, how can we pitch that to journalists?

Beth Daley: Journalists are interested in stories, particularly investigative reporters, that have harm to them. We want to help the public. Usually, we want to prevent harm, so if there’s a story and there’s documentable harm, and someone can bring that to a reporter like myself, that’s a very big bar.

Most of the time we get pitched story ideas as a subject area like, “Can you do a story on informed consent?” or “Can you do a story on sea walls?” or something like that, which is fine. It’s worth looking into and there’s like a germ of an idea, but it takes more time to develop.

What happens when you pitch me a story or someone else pitches me a story, I look at it, I file it away and I gather, what I call, string on it. I read a lot. String means if I read something, I’ll file something in a Word document that says, “This is about informed consent possible harm.” Over time, if that file gets bigger, it often tips a balance that I would actually devote time to it.

For me, to devote time to a subject is not like a daily news reporter. I’m devoting two months, three months or five months, so it’s a big investment and I have to be sure there are many ideas.

At any one time, I’m working on two stories, but probably five different ideas, one of which will be the next story.

Helen Osborne: Wow. For our listeners, maybe we’re not pitching them for investigative reporting. That’s, as you said, an incredibly high bar. What about those daily news stories?

Beth Daley: You want to make them human. You want to have person in them. You want to make them timely. You want to make them have news value, which is timeliness.

When people pitch me successful stories, they’re interesting, they involve people and they have some timeliness to them. Those three things are very important.

You have to understand that reporters are pitched all day long by a lot of people, so you’re one of many. If you work for a company, I can pretty much guarantee you that a reporter is going to be less likely to listen to you pitch a product versus a regular person who’s concerned about some issue in their life.

It usually has to really affect the common person and it’s usually something meaty. It’s not about a product or something someone developed.

Helen Osborne: Beth, I’m tickled and delighted that you at least accepted my pitch to be a guest on Health Literacy Out Loud. We just approached this a different way. I am really fascinated and learning so much as you’re sharing the inner workings of journalism and how we play a part in it together.

How about people learning more? Are there any resources you would steer them to on this? We’ll also have a few on your Health Literacy Out Loud web page.

Beth Daley: Go to reputable news sources to get your health news. There are a lot of them.

Helen Osborne: Can you just give the websites of the NECIR?

Beth Daley: It’s www.NECIR.org.

Helen Osborne: That’s the New England Center of Investigative Reporting.

Beth Daley: CNN is great, and The New York Times and Wall Street Journal. They have very well balanced, good stories. Also, if you’re looking for information about disease or a condition, go to the CDC, which is the Center for Disease Control and Prevention.

Helen Osborne: Thank you for that. Listeners, keep coming back to Health Literacy Out Loud so you can hear from the people doing the work about all these great places to go and what they’re working on.

Beth, thank you so much for doing all you do and for sharing it with us on Health Literacy Out Loud.

Beth Daley: Thank you so much for having me.

Helen Osborne: As we just heard from Beth Daley, journalism and understanding health news is a part of health literacy too. It can be pretty complicated to put all these different moving pieces together.

For help clearly communicating your health message, please visit my Health Literacy Consulting website at www.HealthLiteracy.com. While you are there, sign up for the free monthly e-newsletter, What’s New in Health Literacy Consulting.

New Health Literacy Out Loud podcasts come out every few weeks. Subscribe for free to hear them all. You can find us on iTunes, Stitcher Radio and www.HealthLiteracyOutLoud.org.

Did you like this podcast? Did you learn something new? If so, tell your colleagues and tell your friends. Together, let’s tell the whole world why health literacy matters.

Until next time, I’m Helen Osborne.

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"As an instructional designer in the Biotech industry, I find Health Literacy Out Loud podcasts extremely valuable! With such a conversational flow, I feel involved in the conversation of each episode. My favorites are about education, education technology, and instruction design as they connect to health literacy. The other episodes, however, do not disappoint. Each presents engaging and new material, diverse perspectives, and relatable stories to the life and work of health professionals.“

James Aird, M.Ed.
Instructional Designer