This article was emailed to me by no more than seven different people, and shared widely on social media, but I can’t help but feel we’re preaching to the proverbial choir. What was different about Nieman’s article is that she specifically called out how unhelpful it is when people tout the feel-good wistfulness of libraries of old: “If we allow ourselves to indulge in nostalgic middle-class ideas of quiet places and well-stuffed bookshelves, then we have failed to understand them too. In fact, we have endangered them.”³

Nieman argues that portraying libraries in this golden-hued light inadvertently labels them as a non-essential service. When deciding how to spend a shrinking municipal budget, a quiet haven for books palls in comparison to a new police car. Additionally, this representation of libraries of the past is simply not accurate. While books have been a mainstay of libraries since their inception, public libraries have always been institutions where those of lesser means can come and access resources and information. By not specifically highlighting how the work of public libraries impacts disadvantaged populations we’re simultaneously selling ourselves short, reinforcing the idea that libraries are for some and not all, and slowly but surely digging our own grave. Our advocacy must start getting real about who is using our libraries and for what reasons. A public building is intended for public use, and not just the version of the public that people feel comfortable being around. Our facilities, services, programming and materials should be able to be used by even the most marginalized in our societies. Otherwise we’re not doing our job and assisting in its demise.

The Pennsylvania Library Association recognized the need to assist libraries with reframing their advocacy to highlight the essential services that they provide. The PA Forward program leverages public-private partnerships to bring programming to libraries that address five literacies that are necessary to succeed in the 21st century. These literacies include Basic, Financial, Information, Civic & Social, and Health. When libraries demonstrate that their services, programs, and materials fit one of these literacies, their impact and value are demonstrated more clearly. By talking about story time as basic literacy instruction we elevate the work being done to its rightful position. The skills associated with these literacies are necessary for success in today’s world and we provide that support- for free! So, while it may be uncomfortable, I believe it is our duty to crawl into the dark corners of our communities, shine a light on their needs, and adjust our services to serve them. When we tell those stories, its harder to ignore our value. By doing this we’re remembering our whole community, and not just those that wax philosophical about the dusty shelves of their small-town library. There is value in that perspective, but it’s not the whole story.

References
1. The Age, “Libraries are About Democracy, Not Just Books,” by Christie Nieman, published 10/8/18. https://www.theage.com.au/national/victoria/libraries-are-about-democracy-not-just-books-20181009-p508k7.html. Accessed 10/19/18
2. The New York Times, “To Restore Civil Society, Start with the Library,” by Eric Klinenberg, published 9/8/18. https://www.nytimes.com/2018/09/08/opinion/sunday/civil-society-library.html. Accessed 10/19/18
3. Nieman, ibid.

The post Reframe Advocacy to Highlight Library’s Essential Services first appeared on Public Libraries Online.

In the book, you go over the scientific research that shows how childhood adversity is a risk factor for many of the most common diseases. When did you first make the connection between childhood adversity and a patient’s physical health?

The first time I started putting it together concretely was with Diego, who is a seven-year-old boy I first saw in 2007, which is actually the first year the clinic was open. His presentation was so striking—he had essentially stopped growing—that it really made me ask that question about whether the two could be linked. I feel like the trauma he experienced, I don’t want to say it had to be connected, but looking at the pattern, it looked very connected. This was not a coincidence; this was actually having an impact on his body.

You follow the patient histories of many patients, including Diego, in the book. Why was it important for you to put a human face on childhood adversity and toxic stress?

Because I think that probably our biggest obstacle is myth and misinformation. It’s this idea that childhood adversity is a story we think we know. Many people think, “Well, I know a guy who grew up in a terrible situation and now he’s the CEO of a company.” People have this conception that if you don’t have any behavioral problems it means you’ve left all your childhood adversity behind and it doesn’t have an impact on you. The science does not show that. What the science shows us is that childhood adversity changes our bodies in ways that are lifelong. It doesn’t have to be this awful “woe is me” situation, but people do need to understand if they’re at increased risk for health conditions.

Can you talk a little about what are these long term effects childhood adversity on people’s health?

When I first read the Adverse Childhood Experiences study, what was so striking to me—aside from how incredibly common childhood adversity is—is the fact that what we’re talking about is increased risks for things like heart disease, cancer, chronic lung disease, and Alzheimer’s. What’s amazing to me is that if a person has a very high dose of adverse childhood experiences, their risk of heart disease is the equivalent of eating thirty-three strips of bacon a day. We know that eating bacon is bad for your heart and it increases your risk of heart disease, but what we didn’t know is that having a very high number of adverse childhood experiences increases your risk of heart disease even more that eating a ton of bacon. So when I saw that connection to chronic disease, that was just really powerful.

The other area that I focused on was the science behind how early adversity causes these long-term changes in our brains and bodies. When we understand how these changes happen, for me that’s the hopeful part, because we can use the science to interrupt their progression. When it comes to toxic stress, the fundamental mechanism is our fight or flight response. It’s the release of stress hormones, including adrenaline and cortisol, that have all of these effects on our bodies that are designed to save our lives. It affects the way our brain functions, it raises our blood pressure, and increases our heart rate. All of that is really good if you are in a forest and you need to get away from a bear. The problem is when this process is activated too often, it goes from being life-saving to health-damaging. We see this in children since they are especially sensitive to repeated activation of the stress response because their brains and bodies are still developing. So when kids are exposed to high doses of adversity, it actually changes their developmental trajectory. It changes the way their brains, their hormonal systems, and even their DNA functions for the life course.

You mentioned the Adverse Childhood Experience (ACE) study and in the book you talk a lot about ACE scores. Can you explain what the ACE score is?

The ACE score comes from this groundbreaking study that was done by the Centers for Disease Control and Prevention and Kaiser Permanente, the health care group. In that study they asked 17,500 people about their adverse childhood experiences. They asked about ten categories, including physical, emotional, and sexual abuse; physical and emotional neglect; growing up in a household where a parent was mentally ill or substance dependent; growing up where there was parental separation or divorce; and growing up where there was parental incarceration or domestic violence. For every yes a person answered, they would get a point on their ACE score. When you totaled up that number, that’s your ACE score.

One part of the book that I thought was striking was how you remove any shame around having a high ACE score and instead treat it as piece of information.  If someone has a high ACE score, what can they do?

Well that’s what for me is so important, there’s a lot that people can do. It starts with recognizing that their ACE score might mean they have an overactive stress response. Just recognizing when their stress response is kicking in and whether it’s healthy or not is really important. What I talk about in the book is there are six interventions that there’s strong evidence reduce stress hormones, reduce inflammation, and enhance neuroplasticity, which is the ability of brain cells to connect to each other.

All of these work to heal the impacts of an overactive stress response. They include things like meditation; getting regular sleep and having good sleep hygiene; good nutrition, particularly a high-lean-protein, low-fats, low-sugar diet; getting at least an hour of exercise a day; good old fashioned mental health care; and healthy relationships.

I think healthy relationships is a really critical piece because we as human beings have the ability to not just trigger each other’s stress response but also buffer each other’s stress response. My point in the book, and I don’t think that I can overstate it, is having these networks in your life, having “the village,” doesn’t just feel good, it can actually improve your health and possibly save your life.

Even though there’s a lot of scientific research in the book, you present it in a very accessible manner. For you, who is the ideal reader of this book?

Everyone. I think that there’s no one who doesn’t need this book. For me, understanding that early adversity changes our bodies in this way is a little like understanding that microbes cause infections. There’s no one who doesn’t need to know that, because we all need to wash our hands, right? We should all cough into our elbows. This is really a matter of public health.

It doesn’t matter if you have kids or you don’t have kids. If you’re an adult, you once were a kid. And particularly for anyone who comes into contact with young people, who works with young people, who makes policies about young people, who comes in contact with or makes policies for parents of young people, it’s necessary. I think that the whole point of a public health movement is that every single one of us has a role to play in solving this crisis.

What role can librarians play?

I was at the Philadelphia Free Library last night for my book kick-off event and it was just such a powerful reminder that libraries are these hubs of civic engagement. They’re these places where families come, where people connect into the world of books and literature, and where people come for resources. So my hope is that librarians will be part of being on the front lines of shouting from the rooftops to talk about this work and and connect families to this resource and this information.

The post Every Single One of Us has a Role to Play in Solving this Crisis: Dr. Nadine Burke Harris on Childhood Adversity first appeared on Public Libraries Online.

Whether they’re searching the Internet, watching television, or browsing social media, Americans are bombarded with information related to their health, but the messages they’re receiving may not be understandable, reliable, or even credible. Faced with confusing medical terminology, conflicting reports, and a constantly changing healthcare system, people are looking to their local public libraries for guidance. That’s why the National Network of Libraries of Medicine (NNLM) is partnering with the Public Library Association (PLA): to help libraries meet the challenges of keeping up with evidence-based health resources and producing successful health programming.

Announcing Promoting Healthy Communities

PLA and NNLM are thrilled to announce Promoting Healthy Communities, a new nationwide initiative that will increase public library workers’ health knowledge and skills related to reliable health information resources, as well as support programs related to health and wellness. Throughout the nine-month initiative, PLA and NNLM will:

· Assess health information needs among public librarians in order to improve existing educational opportunities and develop new ones designed to meet the unique needs of public libraries.

· Share free resources, information about successful library programs, and professional development opportunities by holding training programs and webinars, publishing articles and podcasts.

· Unveil a new website (coming in early 2018) for public librarians that gives them easy access to training, tools and resources for consumer health information, health literacy programming and more.

Join Us In Person

The Promoting Healthy Communities initiative will include two in-person learning opportunities.

· “Public Libraries Supporting the Health and Wellness of Your Community,” Sunday, Feb. 11, at the 2018 ALA Midwinter Meeting in Denver. At this “unconference” event, attendees will be invited to connect with their fellow librarians to discuss the health-related topics that are most relevant to their needs. The session is open to all Midwinter Meeting registrants. Learn more and register for the Midwinter Meeting.

· “Stand Up for Health: Health and Wellness Services for Your Community,” Tuesday, March 20, 2018, at the PLA 2018 Conference in Philadelphia. This one-day preconference will review core competencies of providing health and wellness services; coach participants through understanding their communities’ needs; and explore how to create fun and informative health-related programming for different age groups and special populations. Pre-registration is required, and up to fifty $500 stipends are available. Learn more about the stipend opportunity.

Other Ways to Connect

Public librarians can find their regional office and access its resources at https://nnlm.gov/regions.

NNLM offers a wealth of resources that public libraries can use to engage their communities on specific health topics, such as:

· health outreach, nutrition and food labels, and health insurance;

· funding opportunities and awards available to public libraries; and

· microlearning videos to inform library staff about NNLM resources.

Finally, as Health Literacy Month (October) draws to a close, take advantage of the free Health Literacy Toolkit created by NNLM and the American Library Association (ALA). The toolkit includes customizable tools to raise awareness of how libraries support health literacy in their communities, including key messages, program ideas and downloadable marketing materials.

We look forward to connecting with you in the months to come.

This project has been funded in whole or in part with Federal funds from the Department of Health and Human Services, National Institutes of Health, National Library of Medicine, under Grant Number 1UG4LM012346-01 with the University of Iowa.

The post Promoting Healthy Communities: Connecting Public Libraries with Health Information first appeared on Public Libraries Online.

Recognizing this gap in sufficient health literacy, organizations from multiple sectors (including the Institute of Medicine, Public Library Association, and Red Cross) have contributed to the National Action Plan to Improve Health Literacy. The plan emphasizes the importance of cross-sector collaboration and authentic community engagement, particularly to “support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community.”[4]

Public libraries are trusted community institutions that provide the information literacy expertise, community convening capacity, technology infrastructure, and equitable access to reliable resources that can improve health literacy. And community demand for these services is strong.

The Opportunity for All report notes that in 2009, an estimated 28 million people used public library computers for health and wellness purposes, such as learning about a disease, medical condition or illness, learning about diet and nutrition, or learning about a medical procedure. Patrons also reported using library computers to find doctors, identify support groups, and connect with healthcare providers.[5]

According to the results of the 2014 Digital Inclusion Survey, public libraries in the United States advance equal access to health information in many ways.

o 59.4 percent of libraries help patrons identify health insurance resources;
o 57.7 percent help patrons locate and evaluate free health information online;
o 48.1 percent help patrons understand specific health or wellness topics;
o 22.7 percent offer fitness classes; and
o 18.1 percent bring in healthcare providers to offer limited healthcare screening services [6]

This help occurs in many forms, such as informal point of use assistance, training from a library staff member or volunteer, or programming with local partner organizations. Margot Malachowski, Outreach Librarian with Baystate Health in Massachusetts, describes ways in which public libraries contribute to the “patient activation” process by providing skilled referral to physical, digital, and community-based resources.[7] By framing these contributions in the context of health literacy as well as the federal Healthy People 2020 initiative for public health improvement, it is clear that public libraries are an asset to the consumer health information ecosystem.

OCLC’s Health Happens in Libraries program was designed to magnify the role of public libraries as key contributors to community health. The program team recently produced a free, downloadable infographic for public libraries to use in conversation with patrons and other community collaborators about the many dynamic ways public libraries build healthy communities.

In the second article of this three-part series, we will share a brief overview of the evolution of this program and the resources developed for public library staff to take action on community health priorities. Part III will feature key learning from community health engagement efforts with five public libraries.

Erin Schadt and Kendra Morgan contributed to this article.

Note: This article is an extension of a poster presentation from OCLC and program partners from ZeroDivide at the American Library Association annual conference in June 2015 titled “Health Happens in Libraries through Community Engagement.” Comprehensive program resources can be accessed at http://oc.lc/ehealth.

Resources

National Action Plan to Improve Health Literacy (PDF), U.S. Department of Health and Human Services

Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries, The U.S. IMPACT Study

2014 Digital Inclusion Survey: Survey Findings and Results

Healthy People 2020

Health Happens in Libraries infographic

References

[1] L.W. Jackman, “Health Literacy: A National Responsibility—Our Brothers’ Keeper,” College & Undergraduate Libraries 20, no. 1 (2013): 95–106, doi: 10.1080/10691316.2013.761028.

[2] Mark Kutner, et. al., The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy, (Washington, D.C.: U.S. Department of Education, National Center for Education Statistics, 2006): 483.

[3] “Title V: Health Care Workforce,” Affordable Care Act (U.S. Department of Health and Human Services, 2015): 1,252.

[4] National Action Plan to Improve Health Literacy (Washington, D.C.: United States Department of Health and Human Services Office of Disease Prevention and Health, 2010): 2.

[5] Samantha Becker, et. al., Opportunity for All: How the American Public Benefits from Internet Access at U.S. Libraries (Washington, D.C.: Institute of Museum and Library Services, IMLS-2010-RES-01).

[6] John Carlo Bertot, et. al., 2014 Digital Inclusion Survey: Findings and Results (College Park, MD: Information Policy & Access Center, University of Maryland College Park, 2015).

[7] Margot Malachowski, “Patient activation: Public libraries and health literacy,” Computers in Libraries 31, no. 10 (2011): 5.

The post Health Happens in Libraries Part I: Public Libraries Promote Health Literacy first appeared on Public Libraries Online.

The primary goal of Health Happens in Libraries is to increase the capacity of library staff  to respond to patron requests for information regarding the Affordable Care Act. Libraries are uniquely situated to help patrons sift through the information and point them in the direction of qualified, professional help. Librarians can take part in regular free webinars and other training opportunities through the program. Additionally, they may subscribe to news updates to keep abreast of trends and hot topics.

Health Happens in Libraries also provides librarians a chance to share their success stories so we can all generate new ideas for health programming. Check out out the Library Stories section – you’ll find tons of great ideas: http://www.webjunction.org/explore-topics/ehealth/library-stories.html.

References
[1]http://webjunction.org/explore-topics/ehealth.html

Further Reading
http://www.imls.gov/assets/1/AssetManager/OppForAll2.pdf

The post Health Happens in Libraries first appeared on Public Libraries Online.