The first step is to raise awareness. The public needs to be educated, prepared, and vigilant.
How many people out there seem unaware of things like cancer, though?
“Awareness” is a big buzzword in public health, and it’s hard to argue against—sure, it’s probably good for people to be aware of diseases and health risk factors. But do these awareness campaigns—the nearly 200 official U.S. “health awareness days” and the scores of others put on by companies and organizations—actually translate to any real-world action? Do they inspire people to eat better, exercise, or get tested?
They may inspire people to donate to research or to advocacy organizations. And that’s not nothing. But a literature review published last year in the American Journal of Public Health found that there haven’t been many studies done evaluating the efficacy of awareness days, and the few that have been done weren’t designed very well. One recent study analyzed the Great American Smokeout (an anti-smoking awareness day held on the third Thursday of November) and found that on the day, there were 61 percent more news stories about quitting smoking, 13 percent more tweets, 42 percent more calls to quitting hotlines, and 25 percent more quitting-related Google searches, than would be expected on a normal day.
So if the point is to get attention, that particular awareness day seems to be successful. But how many people actually quit smoking because of the Great American Smokeout? We don’t know.
There are cases where public awareness, or I might prefer to call them “information campaigns,” are totally needed—in the case of emerging diseases for example, or ongoing outbreaks. During the Ebola outbreak, people needed to know how the disease was spread, how to protect themselves, and where to go to seek care. The current outbreak of Zika is a case where medical knowledge about the disease is still developing, and so updates on what we’re learning are particularly valuable.
But awareness for the sake of awareness is a goal that seems, at least, questionable.
One concrete thing we can do is encourage people to get screened for diseases. If we catch them early, we can save lives.
Do the benefits of testing always outweigh the harms?
At first blush, it’s hard to see what the harms could be. You’re being proactive about your health! You’re giving doctors more time to treat and help you if they do find something. But false positives are a real danger with many kinds of screening tests, and they can lead not only to unnecessary stress and anxiety for a patient who is actually fine, but to invasive follow-up tests like biopsies. And for some cancers—even if there is a tumor there, it may be one that’s never likely to grow, that a patient can live with indefinitely with no ill effects.