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 my conversations with some really remarkable people.

Today, I’m talking with Michael Jackman, who is District Director for Massachusetts Congressman William R. Keating. Mike has a long history of public service and community outreach in the areas of health and safety, crime prevention and wellness.

He is involved with numerous initiatives and now chairs a Community Health Network Alliance, or CHNA, called the South Shore Community Partners in Prevention. Health literacy is a key component of much of Mike’s work.

The first time I met Mike was when he asked me to speak at one of his programs. The second time was when Mike accepted a proclamation from Massachusetts Governor Charlie Baker, proclaiming October as Health Literacy Month. Mike was wearing a red Health Literacy Hero cape that he so justifiably earned.

Welcome to Health Literacy Out Loud, Mike.

Mike Jackman: Thank you, Helen. I’m wearing my cape right now.

Helen Osborne: I can just feel it over our phone waves. I am very intrigued about how you bridge the gap between elected officials, public policy and health literacy.

Our listeners can be all across the US and even around the world. Let’s just frame this. When we talk about elected officials, who are you thinking about and what do you mean by that term?

Mike Jackman: Elected officials on every level can have an impact on health policy, funding and decisions that affect health outcomes for people all across the country and all across the world, really.

Helen Osborne: Is it local? Is it regional, state or national?

Mike Jackman: Absolutely. Of course, we just had a presidential election, so everyone knows the president in the U.S., the U.S. Senate and the US House, which is the body that I work for, have committees that deal with healthcare issues and healthcare financing issues.

They are voting every day on bills, such as the 21st Century Cures Act, which we can talk about in a little bit. Medicare and Medicaid are decided at the federal level by those legislators. Those are important decisions.

On the state level, many states or most states have a governor. Every state has a governor, but most states have two bodies of the legislature. There’s the House and the Senate in Massachusetts.

Some places it’s called the State Assembly, the General Court or different names, but generally speaking, all of those bodies also have important decisions that they make on healthcare issues.

In Massachusetts, the state House and Senate both have healthcare committees and healthcare financing committees that talk about how Medicaid is administered locally on the state level.

Helen Osborne: In the big picture, people are making big decisions. Those are the ones we hear about in the national papers. Then you’re saying state. What about the local? I’m thinking about in my town, which is not the same as your town, of what’s happening locally too. I think that’s making a difference. Tell us more about that.

Mike Jackman: At the local level you have, again, this generally legislative body, if you will, like a board of selectmen or a town meeting. Some municipalities obviously have a town mayor or a city manager who is the executive of the town. Then there are boards of health often, planning boards and different boards that have decisions that impact people.

I actually went today, as we speak, to a meeting about the new law here in Massachusetts that was passed during the election on legalizing marijuana possession.

Helen Osborne: Let’s use that as an example. I’m really interested between elected officials and policy, and how that affects health and what we care about and do in health literacy.

That’s an interesting example that’s happening around the country more and more. Our state just voted for recreational marijuana use and, as I know from watching TV, our elected officials, for the most part, aren’t thrilled with that, right?

Mike Jackman: It’s interesting. I think, when the question was first posed as something that would be on the ballot, generally there were some pro feelings, or some favorable feelings towards it.

As a lot of the state legislators here in Massachusetts looked to the example of Colorado and Washington, which already have the legalization of recreational marijuana in place.

Looking at the example and some of the problems that they’ve seen in those states with increased operating under the influence incidents, higher costs for drug treatments and other issues like that and associated healthcare costs too, I think the favorability amongst the legislators who realized that they would have to implement this law at the state level . . .

Helen Osborne: Whether they want to or not.

Mike Jackman: Exactly. Of course, in Massachusetts, we have the initiative petition, which is the referendum that just overwhelmingly passed at the election in November, to allow the legalization of recreational marijuana.

Helen Osborne: That’s a really interesting example of an initiative petition. You go to the grocery store and they ask you to sign a petition. That somehow gets on the ballot. Then it got overwhelmingly voted for and now our legislators have to come up with a reasonable way to make that happen. That just seems like this huge cascade of things that happen in there.

I’m really intrigued. How can we as individuals or someone who cares a lot about health literacy and health communication be part of that process?

Mike Jackman: The initiative petition is just one example of what they call direct democracy, where people vote on what becomes a law and what doesn’t become a law.

Democracy or the democratic process in general is where legislators make laws and executives, whether it’s the governor or the president that signs those laws and implements the laws. People can certainly have quite an impact on those as well.

Working for a congressman as I do, every day we hear from people in our district, or constituents, who are calling to voice concerns about legislation, policies or things that are going on down in D.C. that they’re reading about, hearing about or seeing on TV.

That voice is very important. It has a huge impact, I think, on the decisions of members of Congress, State Legislators and even local legislators.

You think of your Board of Health or your Board of Selectmen. They really are responsive to the advocacy on that level.

Helen Osborne: They really listen to us, like when you see a campaign like “Email your congressman”?

Also, for those listeners who don’t know, Congressman Keating is in Washington, D.C., representing a District of Massachusetts, so he’s in the national Congress.

They really listen? It just seems like they’re going to get so much information. Why me? Why would they listen to my call or my email?

Mike Jackman: The job of the congressman is to represent the people who elect him or her, and you can only do that effectively if you’re listening to those people.

I think any individual member of Congress faced with a decision on the floor of the House whether to vote yea or nay or whether to propose a bill or oppose a bill, they have a lot of different factors that influence that decision.

It could be information that they received at a hearing, whether it’s a hearing by the Healthcare Committee or by whatever committee that legislator serves on.

It could information that they’re getting from lobbyists or special interest groups, but another big part of it is the information or the voice of their constituents, regular people like you and me calling in or emailing in on a daily basis.

Helen Osborne: Mike, I’ve tried this. I’ve tried speaking up. One time I was sitting next to my state rep at a meeting. It happened to be on opioid abuse and it’s a little scary to be sitting next to him. You do this all the time. What words of encouragement do you have for those of us who find it a little scary to speak up?

Mike Jackman: I guess the best thing I could say is don’t be scared. He’s a person just like you. He puts his pants on with two legs just like everyone else. I guess that’s the old saying.

Those folks who are elected and making those decisions are people. They are people first and they are sensitive to concerns of other people when they hear a story that could impact their decision.

If there’s a law or policy that is having a negative impact on someone and then that person expresses that to the legislator, that’s going to have an impact. They’re people too.

It’s funny. Having done this for a while, I’m on the other side of it. I don’t hear from people who are afraid or have reticence about calling their legislators, but I know there are people out there like that, so I would just say that email is an effective way to do it.

If you want to write a letter, if you want to take time to collect your thoughts and put it down on a piece of paper, that’s always effective too. I think the phone call is good because it’s directly calling the office and getting in touch.

Helen Osborne: Who will you speak to? Will you speak to a staff person like you or will you speak to the congressman himself?

Mike Jackman: There are different opportunities to actually speak to your congressman. You can always call and ask for an appointment.

I know, with Congressman Keating, we often hold meetings with constituents. We also have events where he goes out and he’ll go to a coffee shop and let people know that he’ll be there for a few hours. They call it “Coffee with your congressman,” “Congressman on your corner” or something like that.

If you see that one of those is going on, even if you don’t have an issue that’s a burning or pressing issue right away, I would encourage people to go to those events just to meet their congressman and say, “Hi, I’m so and so, and I just wanted to say hello.”

That might act against some of that reticence and reluctance to actually reach out when you do have an issue that’s important to you, because then you know you’ve established some kind of relationship with that member of Congress.

Helen Osborne: You’re giving me some level of courage here. I have reached out sometimes.

I know you’re wearing your red Health Literacy Hero cape and you also talked about how our elected officials do make decisions about things that affect funding and health policy. Where do you see as opportunities for those of us who care so much about health literacy as far as the connection with our elected officials?

Mike Jackman: I think the proclamation that you mentioned is a good example.

Helen Osborne: Proclaim Health Literacy Month.

Mike Jackman: Exactly. That’s something that you had initiated and we’ve been working with you as a group. We wanted to take the next step to get that proclamation from the governor.

Helen Osborne: Let me just share with the listeners how that happened. I met you the first time at one of your meetings and you were just really easy to talk to.

We were just saying our goodbyes and thank yous and you said, “Hey, is there anything else I can do?” I said, “October is Health Literacy Month. It has never been proclaimed in my state and I am clueless how to have that happen.” You said, “Done,” and it was done months later.

I spoke up, I said something that I thought was worthy and you did all the other parts that were in your world. To me, that was a very nice pulling together.

It sounds as though the proclamation that Governor Baker signed has a lot of details and nuances about health literacy, about really what it means to our members of our state.

Mike Jackman: I think the proclamation, as you said, reflects the fact that we are pursuing health literacy on our level because we want to improve health outcomes for people in our region, but I think the whole state could really benefit from health literacy too.

I think it’s interesting that it’s a concept that I, having worked for an elected official for many years, was not familiar with as recently as four or five years ago.

Helen Osborne: Health literacy, you mean.

Mike Jackman: The more work that I’ve done, I’ve become more familiar with it. I think you have to be intentional in dealing with elected officials to make sure that they become familiar with the concept and what it means, and how health literacy and improved health literacy can be beneficial for their constituents and for the people that they represent.

We can definitely talk about different ways that people can bring health literacy to their elected officials’ attention.

Helen Osborne: I was just curious about that. Is it through stories or statistics? Is it through peer reviewed articles or something in the press? Is there one way that makes the most compelling argument?

Mike Jackman: That’s interesting. I think phone calls and personal stories are the best.

Helen Osborne: Should we give it some statistics and say, “The National Academy on Medicine says this,” or, “This group says that”? Should we go with bringing a lot of information from many people, or should we come with our own personal viewpoint and stories saying, “Here are people I treated,” or, “Here’s my family”?

Mike Jackman: I think they both can be effective. I think statistics are great. Legislators are very data driven. If they can see that there’s a connection between health literacy and outcomes, I think that’s really important, but also the personal stories too.

Health literacy, I think, and communications in health, you have to reframe them through your own personal viewpoint, which is what I’ve tried to do.

Health literacy was a concept for me, but in the last few years I personally have had some doctors appointments and different health things that I had to go through. It made me think, “How am I communicating with my healthcare providers and how are they communicating with me? Am I prepared to ask questions? Am I taking time to make sure that I understand everything that’s being told to me?”

You have to personalize it like that for yourself and for the elected officials, I think, and just familiarize them with the concept. I do like the idea of statistics and trying to take a data-driven approach as well.

Helen Osborne: I love that, how you bring the personal and the data, bring it to your congressman and maybe we can see things move forward.

I know you’ve got a wealth of tips and there’s so much people can be doing, but just give a quick view of how listeners could be learning more about who to contact in their state what the best way is to contact somebody. How would someone go about finding that information, at least in the US?

Mike Jackman: On the federal level, for the House and the Senate, the easiest thing to do is to go on the internet and look up www.House.gov. It lists every member of the House of Representatives on there. www.Senate.gov is for the Senate. They’re very easy to remember.

Helen Osborne: We’ll have that on your Health Literacy Out Loud web page too.

Mike Jackman: Great. You can find out who your representative is. Every state has two senators, but members of the House depends on the population in your state. You can find out who that person is, how to get in touch with them and how to reach out to them.

We get many calls and emails every day, so it’s nothing new for us, but I totally understand that it might be new for someone who hasn’t thought that they should be reaching out to their member of Congress.

For the state legislators, I guess whatever state you’re in, go to that state’s website. I guess a quick Google search is the easiest way to find that if you don’t know what it is.

Find out who your legislators are. That’s even a closer level because a state legislator will represent a smaller number of people than a member of Congress will be, in most cases, and there’s a more direct connection, I think, with that person.

Of course, your local town is even a closer connection because the selectman, the Board of Health or mayor for that town or city know that you’re a resident of that town or city, and they know that they have to represent you and listen to your concerns.

Helen Osborne: Thank you. Actually, I tried that at different levels in getting involved and I became a member of my town’s commission on disability for a number of years. Think global and act local.

My takeaway message from you, Mike, is to speak up. We have to advocate for health and health literacy. It’s more important than ever. There are people around that are just waiting to hear from us.

Thank you so much for doing all you do. Keep that cape on. Thank you for being a guest on Health Literacy Out Loud.

Mike Jackman: My pleasure. Thank you, Helen.

Helen Osborne: As we just heard from Mike Jackman, it is important to contact elected officials too about health literacy. But doing so and advocating for health and health literacy is not always easy.

For help clearly communicating your health message, please visit my Health Literacy Consulting website at www.HealthLiteracy.com. While you are there feel free to 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 the Health Literacy Out Loud website, www.HealthLiteracyOutLoud.org.

Did you like this podcast? Even more, did you learn something new? I sure hope so. If you did, 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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