HPH NOW, Mar 30, 2007, Communicating Health Risks to African American Audiences Was Topic of Hinton Lecture

Garth Graham

Garth Graham of the U.S. Department of Health and Human Services (HHS) recalled that during the aftermath of Hurricane Katrina, he and other government health officials met with residents of storm-ravaged New Orleans. "It was very important that we learn from that situation to involve communities early on in a dialogue," Graham told HPH NOW.

Graham, who is Deputy Assistant Director for Minority Health at the HHS Office of Minority Health, delivered the keynote address at the annual William A. Hinton Lecture on March 12 in Kresge G-2. He emphasized that risk communication is an interactive process that involves both talking and listening to targeted audiences.

The event was jointly sponsored by the HSPH Division of Public Health Practice and the Massachusetts Department of Public Health.

William A. Hinton, for whom the lecture is named, was one of the first African Americans to graduate from Harvard Medical School, where he later served as Clinical Professor of Bacteriology and Immunology. In the 1920s, Dr. Hinton developed the widely used Hinton Test for the diagnosis of syphilis.

The lecture brought together Graham and a panel of speakers who addressed the challenges of communicating health risks to the African-American community and to other minority groups, particularly in light of historical trauma, increased perceptions of risk, and differing communications outlets used by various populations. The event was moderated by Elmer Freeman, Executive Director of the Center for Community Health, Research and Service in Boston.

Graham pointed out that public health officials must keep history in mind when reaching out to the African-American community, particularly in light of such events as the infamous Tuskegee Experiment. This clinical study by the U.S. Public Health Service ran in Alabama from 1932 to 1972 and involved poor African-American sharecroppers with late-stage syphilis. The study became notorious partly because the subjects were not treated for the disease, despite the availability of treatments, and were left to succumb to the disease's ravages. The eventual outcry led to the establishment of standards for clinical trials. Graham noted that the study has triggered a lingering distrust among blacks of the health care system.

"Historical events such as Tuskegee leave a lasting impression on communities, one that we must actively work on to improve,'' Graham said to HPH NOW in a follow-up.

Kalahn Taylor-Clark, a research fellow in the HSPH Department of Society, Human Development, and Health, shared the results of a number of public opinion surveys showing differences between blacks and whites in terms of their perceptions of various potential health threats.

According to surveys led by HSPH Professor Robert Blendon, African Americans are more concerned about avian flu, infectious diseases, and biological agents than white Americans surveyed, she said. Why is this important? Taylor-Clark explained, "Without effective communication, increased risk perception may lead to inappropriate behavior.''

Taylor-Clark said that blacks are also more skeptical of a variety of sources of health information, ranging from the news media to government officials. At the same time, she said, African Americans are more likely than whites to seek government help in public health emergencies. She explained, "Racial minorities face greater challenges in recovering from disasters due to social vulnerability and lower access to communication channels.''

In background, Kalahn Taylor-Clark listens to Donna Latson Gittens

Donna Latson Gittens, founder of "causemedia inc.", an advertising agency specializing in conveying public health messages, said that campaigns must be simple and direct - not paternalistic.

Public health communicators must know the best places in which to campaign, Gittens said, asserting that large newspapers are typically less effective than smaller community papers in reaching minority communities.

Other places to promote health messages include ethnic-oriented radio stations, podcasts, and web sites such as YouTube.com and MySpace.com, she said. Posters at health centers and bodegas are also effective, she said.

And those trying to get out messages should recognize the differences among minority groups - and understand which sources of information these groups trust, she said.

During the event, Sally Fogerty, Associate Commissioner at the Massachusetts Department of Public Health, presented two awards. Garth Graham received the William A. Hinton Award, and Donna Gittens received the Rebecca Lee Award, named for the first African-American female physician in the U.S. Closing the lecture was Howard Koh, Harvey V. Fineberg Professor of the Practice of Public Health, who thanked the lecture's participants and the audience.

—ML