By Christina Folz
One of the best things I learned as a consumer health writer is the value of asking — and answering — common-sense questions from a hypothetical reader. For most of us, there is nothing more important than our health, so when people seek information on how to prevent and manage diseases, they really want answers. And why shouldn’t they? The stakes couldn’t be higher.
Writing about health and science for an audience with little or no special knowledge of those topics is far more difficult than writing for experts. With the general public, you don’t have the luxury of relying on jargon to communicate technical concepts. You need to unpack and explain. Every. Single. Thing.
I learned this the hard way from my editor Leah when I worked at the Harvard Health Letter in the late 1990s. She’s now a dear friend but back then she was the subject of many of my nightmares (sorry Leah). Actually it was not her so much as the infernal question marks she scrawled in the margins of every draft I submitted. Sometimes there were three question marks in a row with no other words, pulsing in wet red ink like a fresh wound.
Those question marks haunted me every time I sat down to write a sentence, as did her favorite form of commentary that included actual English words: “because why?”
“Hypertension greatly increases the risk of heart disease.” Because why?
“Osteoporosis is a side effect of long-term steroid use.” Because why?
“Contrary to popular belief, cold weather does not cause colds, although it can lead to pneumonia.” ??? How? Why?
From her, I learned to question every word I wrote — and that’s a good thing. Because the more questions I could answer, the more deeply I understood the topic and therefore the more the reader would grasp it as well. I began to think of good expository writing as writing that is dense with information. Writing with a high information density presupposes every question curious readers might reasonably ask, and then answers it for them.
Consider the difference between these three definitions of high blood pressure:
- Low information density High blood pressure means that the pressure of the blood in your blood vessels is higher than it should be.
- Medium information density High blood pressure, also known as hypertension, occurs when the force of the blood against the walls of your arteries is high enough to cause certain health problems, including heart disease and stroke.
- High information density A person with high blood pressure, or hypertension, has a blood pressure above 140/90 mm Hg. Blood pressure is a measure of both the amount of blood the heart the pumps into the arteries each minute and the pressure that the walls of the arteries exert on the blood in return. The higher a person’s blood pressure, the harder the heart must pump to push the needed amount of blood through the arteries. High blood pressure strains the heart and blood vessels and thus can cause heart disease, stroke, dementia, kidney disorders and eye problems.
The first example provides one piece of information — a rough description of blood pressure as “the pressure of the blood in your blood vessels.” But what causes the pressure? And why does it matter — i.e., what’s the link between it and health? Finally, what does high mean? The sentence defines high blood pressure in circular terms, essentially saying, “high blood pressure is blood pressure that is high.”
The second example makes a connection between blood pressure and health, but it’s not totally clear how the “force of blood against the walls of your arteries” would lead to heart disease and stroke. Still, it’s not a bad definition to use in a pinch, especially in the context of an article on another topic, where you don’t have 100 words to spare explaining an ancillary term.
But in an article or FAQ on hypertension, the final example is the best bet. While every possible question isn’t answered here (what does the 140/90 reading come from? What does mm Hg signify?), it gives people enough information to relate the numbers their doctor told them to the subject at hand. It also explains exactly what blood pressure measures and how it relates to health. Anyone familiar with the basic concepts of plumbing will understand how the hard pounding of a liquid through a narrow network of tubes will strain both pump and pipe.
Just say it
One of my exasperated rejoinders to Leah’s constant “because why” questions would often be: “But no one knows why! Not even the researchers!” She would indulge none of my indignation. Her simple response astounded me: “Then just say that.” While it sounds obvious, it had never occurred to me to just state reality — and, judging from the drafts I edit day in and day out, it doesn’t occur to a lot of other writers or editors either.
Consider the following example (and assume the condition it describes has been defined elsewhere in the draft):
- Low information density Temporal arteritis usually occurs in middle age or later. It affects women more frequently than men.
- Medium information density Temporal arteritis is relatively common in middle-aged and older adults. It afflicts women twice as often as men.
- High information density Temporal arteritis strikes up to 1 in 500 people over age 50 and even more over 60. It affects women twice as often as men, but no one knows why.
The final example provides just a few more words than the first and second, but it tells people so much more. It gives the actual frequency of temporal arteritis and explains what middle and old age is in this context. Moreover, it addresses one of the most obvious questions a reader might have: Why are women affected more often than men? By contrast, the fact that temporal arteritis is common in the 50-plus set doesn’t necessarily require explanation. Most folks understand that our bodies withstand more wear and tear as we age; it’s a known reality — and this is where common sense should enter into your thinking and writing.
The fact that “no one knows why” is less satisfying than giving a definitive explanation, but it’s the best a writer can do in this situation. Now at least the reader won’t be scratching his or her head or Googling to find out information that you could have easily provided. The question has been asked and answered. You’ve done your job.
Christina Folz is the editor of HR Magazine at the Society for Human Resource Management and member of AM&P’s content creation committee.