School of Public Health

SPH news

Posted Date: March 14, 2019

By Sally Crocker

Nphw Banner


National Public Health Week 2019 is on the way.

The week will be celebrated April 1-7, and this year’s theme is “Creating the Healthiest Nation: For science. For action. For health.”

Each day of National Public Health Week (NPHW) – developed by the American Public Health Association (APHA) to recognize the contributions of public health and highlight issues that are important to improving the health of the nation – will focus on a different topic, including healthy communities, violence prevention, rural health, technology and public health, climate change and global health.

NPHW offers a unique opportunity for working together both locally and nationally in helping to create innovative ideas and directions for the future of the nation’s health.

UNTHSC School of Public Health activities are being planned to take part in this initiative, and students, faculty and staff are encouraged to participate in these local events, organized by the UNTHSC Public Health Student Government Association (PHSGA).

SPH events will include a campus health fair, a movie screening and discussions on climate change, a program on ending the cycle of violence in coordination with JPS Health Network Trauma Services, guest speaker visits and other activities.

The week will conclude on Sunday, April 7, with SPH participation in this year’s “Girls Run Red 5K,” supporting efforts to empower young girls and women globally through education and other important initiatives. Registration information for this event can be found on Facebook through this link.

Public Health Week

Posted Date: March 5, 2019

By Sally Crocker

United Way2


A team of UNTHSC researchers has recently completed a comprehensive community assessment for United Way of Tarrant County that will help set the organization’s strategic direction for years to come.

Findings from this extensive study, which uncovered some of the most pressing social issues affecting the health and prosperity of the Tarrant County population, were recently presented at community meetings around Fort Worth, Arlington and the Mid Cities.

Led by Dr. Emily Spence-Almaguer, Associate Dean for Community Engagement and Health Equity at the UNTHSC School of Public Health, along with Dr. Karen Bell, UNTHSC Assistant Professor of Health Behavior and Health Systems, and Project Director Danielle Rohr, MS, the assessment incorporated months of in-depth, one-on-one interviews and focus groups with local leaders, civic representatives and citizens, to not just address areas of need but analyze and determine the root causes for solving them.

Survey participants ranged from age 18 to 96.

Approximately 67% were female, and the research team traveled throughout Tarrant County to speak with a diversity of residents and stakeholders, reaching 91% of local zip codes.

At two million people and growing, Tarrant County is the third most populous county in Texas and the 16th largest in the United States. Yet, 23% of area families earn less than $35,000, making housing unaffordable for many. In 2018, more than 2,000 people were identified as homeless in Tarrant and Parker counties.

Lack of safe shelter and transportation were found to greatly impact health care access and well-being, and basic needs like food, hygiene, electricity and clothing were often found to be overshadowed by larger issues like employment and education.

Overall, the top identified issues for area residents were found to be housing and homelessness; physical/mental health and wellness; transportation; education, childcare, early childhood and youth services; basic needs, emergency assistance and financial stability.

“Many organizations in the community provide services addressing these different needs,” said Leah M. King, United Way Executive Vice President and Chief Operating Officer, “making the goal of this study to specifically determine the best ways that United Way can support and work alongside these partners to have a greater impact for local individuals and families moving forward.”

“While many of these issues are not new,” she said, “the community assessment highlights how they are interconnected and how they compound challenges for residents and their quality of life. The results of this UNTHSC study have helped provide guidance on how United Way can partner, lead, listen and work in providing future leadership and harnessing resources to solve Tarrant County’s toughest social challenges.”

The research was made possible through a $250,000 grant from the Sid W. Richardson Foundation.


Posted Date: February 25, 2019

By Sally Crocker

Litt Lewis Twitter Graphic

Proportion of Users Who Tweeted Each of the Most Common Alcohol Emojis

Young adults’ social media chatter may reveal a lot about drinking behavior and intentions, say two UNTHSC public health researchers.

A new study published in Drug and Alcohol Dependence by Dr. Dana M. Litt, Dr. Melissa A. Lewis and colleagues, examined a random, national sample of 5,000 Twitter posts from young adult drinkers ages 18-20, finding a significant link between alcohol-related tweets, willingness to drink, alcohol use and negative consequences.

The UNTHSC researchers, led by Dr. Lewis, are currently conducting a five-year, $2.4 million study examining an online intervention to reduce alcohol use and related risky behaviors among young adults, funded by the National Institutes of Health (NIH), National Institute on Alcohol Abuse and Alcoholism.

Participants electing to share data from their public Twitter accounts provided insight into the relationship between their social media postings and self-reported alcohol behaviors, attitudes and risk perceptions.

“The majority of social media research in this area has focused on Facebook,” Dr. Litt said. “Few studies to date have looked specifically at Twitter, and of those, most have just looked at trends of alcohol-related Twitter chatter and have not linked them directly to self-reported behavior.  Thus, the relationship between Twitter posts and users’ actual behavior were not really known.”

This new research is also the first to look at emojis as a form of alcohol-related Twitter conversations. Digital images representing clinking beer mugs, wine or cocktail glasses and tropical drinks are some of the more common emojis used to connote drinking.

The research team used custom computer programming to search users’ Twitter content for explicit alcohol-identifying words and slang as well, such as drunk, drinking, hungover, wasted, booze and others. Additional hands-on coding by researchers helped eliminate non-applicable Tweets, like “I can’t stop drinking coffee” or “I dare you to drink a whole gallon of milk.”

Over half of those studied (53%) had posted a tweet with the word “drunk,” and over one third had tweeted a message using the term “wasted.” Over 28% of users surveyed had posted at least one tweet with an alcohol-related emoji.

While demographic variables like gender, age and ethnicity were not identified as predictors of willingness to drink, problem drinking or alcohol-related negative consequences, the research did find that posting a higher proportion of alcohol-related tweets was a positive indicator of all three alcohol-related outcomes.

“This has important implications for parents of teens and younger adults, especially, who may want to set up ground rules on who their kids can follow, or perhaps follow them too,” Dr. Lewis said.

Understanding the connections between Twitter behavior and alcohol-related beliefs and actions, the researchers concluded, can be a key step in identifying those who may be most at risk and in turn, developing public health education and interventions.

The researchers recommend similar, future study into other forms of popular and emerging social networking sites, such as Snapchat and Instagram.

“Social media has created a unique window into people’s thoughts, and our research indicates that there is certainly an association between what you’re posting on Twitter, what you’re thinking about doing and what you end up doing in reality,” Dr. Litt said. “Knowing that alcohol-related Twitter activity seems to reflect one’s actual behavior is important knowledge for researchers, public-health practitioners and parents alike.”

Posted Date: February 19, 2019

By Sally Crocker

Thad Miller Martin OstensenTwo UNTHSC School of Public Health professors – Thad Miller, DrPH, MPH, and Martin Ostensen, JD, MBA, MHA, from the SPH Department of Health Behavior and Health Systems – recently served as expert panelists to provide perspectives and commentary following a recent City of Fort Worth Human Relations Commission community screening of the film Power to Heal, a documentary on Medicare and the civil rights revolution.

The City’s free Movies that Matter series is offered bi-monthly in celebration of diversity and inclusion.

The hour-long Power to Heal tells the story of the historic 1960s struggle to secure equal and adequate access to healthcare for all Americans.

Panel DiscussionCentral to the documentary is the unfolding of a new national program, Medicare, which helped launch a dramatic, coordinated effort that desegregated thousands of hospitals across the U.S. within months.

Prior to Medicare, less than half of the country’s hospitals served black and white patients equally, and in the South, one third of hospitals would not admit African-Americans, even for emergencies. The movie illustrates how this movement toward justice and fairness for African-Americans was achieved.

Dr. Miller and Professor Ostensen both teach in the UNTHSC Master of Health Administration (MHA) program. Ostensen serves as MHA Program Director.

Posted Date: January 16, 2019

By Sally Crocker

Homeless Count
Groups of UNTHSC students, faculty and staff are being organized by the School of Public Health to assist with this year’s Tarrant County Homeless Count on January 24.

Dr. Emily Spence-Almaguer, SPH Associate Dean for Community Engagement and Health Equity, makes this volunteer endeavor part of her public health classes each year, giving students an opportunity to opt out of a quiz by joining in this effort to locate, count and survey individuals spending the night on local streets or in places that aren’t meant for sleeping and living.

Over the years, many others from UNTHSC have joined in to help as well.

The local efforts are part of a larger national initiative that includes police departments, government officials, church and neighborhood groups, nonprofit organizations, universities and other invested citizens across the U.S. who help gather data used to analyze and address the changing trends, extent and nature of homeless across the country.

Information gathered is used each year to measure the progress being made in the community and on a national scale to end homelessness.

According to U.S. Department of Housing and Urban Development data from the 2018 national count, about 553,000 people in the United States experienced homelessness on a single night last year.

About 65% were staying in emergency shelters or transitional housing programs, and the rest were in unsheltered locations, on the streets, in or behind abandoned buildings, under bridges or living in other places not suitable for human habitation.

“Our community saw the Tarrant and Parker county numbers increase by 5% in 2018. On the night of the count, we found 2,015 individuals, as compared to the approximately 1,924 persons counted on the 2017 night,” said Tammy McGhee, Executive Director of the Tarrant County Homeless Coalition.

The numbers are even more staggering, McGhee said, when taking into account the thousands of others in North Texas who are without a stable home, living in week-to-week motels, doubled up with friends or families, or in other precarious and unpredictable living situations.

UNTHSC has long been a partner with the Tarrant County Homeless Coalition, to help address this issue and meet the needs of this population.

“Everyone deserves a safe and adequate place to call home,” Dr. Spence-Almaguer said. “Through the Tarrant County Homeless Coalition and its many partners in healthcare, mental health, education, first response, faith and community services, local government and other areas, thousands are able to access resources each year to help get back on their feet.”

The needs are varied and many.

Mental and physical health, and having necessary prescription medicines available with a place to store them, can sometimes mean the difference between life and death.

For those living on the street in winter or during other extreme weather conditions, McGhee said, there are options available for a warm, safe and dry place to sleep, from temporary shelters and transitional housing to longer-term programs.

Through the Tarrant County Homeless Coalition, individuals can also connect with resources for employment, transportation, family assistance, counseling and other services.

“Housing is one of the most important factors,” McGhee said. “Finding a place to live is the first start.”

UNTHSC has long been involved as an active community partner in various ways, through research and educational programs, planning and advisement, School of Public Health student internships and broad volunteerism.

“Being a part of the homeless count each year helps us learn more about what these individuals need and how we as a community can best help,” Dr. Spence-Almaguer said.

To learn more and be a part of this year’s January 24 Tarrant County Homeless Count effort, visit

More than 500 volunteers are needed to help in Tarrant and Parker counties.

Posted Date: December 21, 2018

By Sally Crocker


Teresa, Shanda And Jamar

Dr. Teresa Wagner at right

Every day, approximately 830 women around the world die from pregnancy or childbirth-related complications.

The number of maternal deaths in the U.S. has more than doubled in the last 30 years, and Texas data is especially concerning, with about 14.6 deaths for every 100,000 births.

Through a new study funded by the National Institute on Minority Health and Health Disparities, UNT Health Science Center researcher Dr. Teresa Wagner aims to evaluate the impact of health literacy on this problem.

“Few studies to date have looked at the effect of health literacy on obstetric outcomes,” Dr. Wagner said. “There is a vast amount of medical instruction provided when leaving the hospital, which begs the question, ‘Are women understanding how to evaluate if symptoms after childbirth are normal, abnormal or requiring urgent medical attention?’”

Dr. Wagner, Assistant Professor in the UNTHSC School of Public Health and Senior Fellow for Health Literacy with SaferCare Texas, formerly known as the UNTHSC Institute for Patient Safety, has spent much of her career working to bring about change in the ways people navigate and understand the complex healthcare environment.

Her recommendations for improved health literacy in Texas have received support across the state and are slated for review in the 2019 legislative session.

“There is so much to process when new mothers leave the hospital and head home that it may be challenging to get a good grasp on all the discharge paperwork and homecare instructions,” she said. “Along with the responsibilities of caring for a newborn, new moms may also be facing sleep deprivation and physical and emotional changes. It’s important that women have a clear understanding of warning signs or complications indicating they should call a healthcare provider or go to the nearest emergency department.”

African American and low-income mothers, as well as women at extremes of the standard maternal age and those from rural areas, are most at risk, Dr. Wagner said.

“Readability, understandability and cultural sensitivity are all important in the way that health information is provided and will be assessed in this new study,” she said.

The project will partner with the UNTHSC Healthy Start program; Family Circle of Care in Tyler, Texas; and the Harris College of Nursing and Health Sciences at TCU, to evaluate current postpartum education and information through national standards assessment models and personal interviews with both urban and rural patients though community programs affiliated with large Texas hospital systems serving low-income patients as part of their demographic mix.

“The innovative aspect of this study is that we will be including women’s own personal perceptions with standard health literacy assessments, to gain firsthand advice and make recommendations on how communications and instructions can be improved as new mothers leave the hospital,” Dr. Wagner said. “The information and opinions they share will be important in helping to improve standards of care for hospitals and keeping mothers safe from preventable harm.”


Research reported in this publication was supported by the National Institute On Minority Health And Health Disparities of the National Institutes of Health under Award Number U54MD006882. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Posted Date: December 17, 2018

By Sally Crocker


Jaime Gonzalez

Dr. Jaime González

Growing up, Dr. Jaime González thought he might one day become a priest.

Life, however, had other plans, taking him on a different path of serving others, through public health and health-related services.

As Chief Business Development Officer for the Health Plan Alliance, a national trade organization that brings health plans, hospitals and physicians together to address patient health and wellness, he is passionate about doing all he can to make healthcare better for all.

“It really started with my family,” Dr. González said. “Growing up as the seventh of eight children, with an even larger extended family of 60-plus cousins on my father’s side and 36 on my mother’s, I learned the lessons of giving and sharing at a very early age.”

Both parents were strongly committed to church and community, and Dr. González’ mother was often the first to visit the sick or lend a hand when someone needed help.

“My dad moved here from Mexico to start a life and a family in Texas, and his commitment to making things better, not just for us, but for others around him, was truly inspiring,” Dr. González said. “Being part of something bigger, of supporting and taking care of each other – our family, friends, neighbors, church and community – showed me what a difference can be made and impacted how I wanted to approach the world in both my career and personal life.”

When Dr. González started working on his DrPH in Health Management and Policy at the UNTHSC School of Public Health, he had already completed a master’s degree in clinical social work and another in health administration.

He had directed clinical case management services related to pediatric intensive care and children’s cardiovascular surgery.

He had worked in the health insurance industry, and had experience with public policy and regulatory affairs.

He was serving in a top leadership role for UnitedHealthcare’s Latino Health Solutions division, developing projects, programs and partnerships to improve health services and healthcare access for the U.S. Latino market nationwide, when he was encouraged by a longtime friend, mentor and UNTHSC professor at that time, Dr. Adela González, to “connect the dots” in his educational experience by adding public health to his professional background and perspective.

“Public health is the ideal standard for serving the community and doing the most good for all,” he said. “Working in the health plan industry, being able to deliver services and resources from a broad, population health view, keeps the focus on what is most important, the patient.”

Today, in his role with the Health Plan Alliance, he oversees multicultural/healthcare equity programming and partners with members across the country on educational opportunities and sharing of subject matter expertise and best practices.

“My job touches on public health every day, whether it involves the social determinants of health, member/patient engagement, health literacy, health education, wellness, or the financial side of serving members efficiently and at a better cost through group purchasing and other programs,” he said.

“If I can help our members improve patient care outcomes, and connect people to information and people to people, then I know that I am doing what I believe in and helping others in the way that my parents taught me growing up,” he said. “My mother used to say that God has a way for everything; this is my way.”

Honors include the U.S. Surgeon General’s Medallion for developing culturally-relevant and bilingual health and wellness resources for UnitedHealthcare’s clients; the National Business Group on Health Innovation in Reducing Health Disparities award; and first recipient of the UnitedHealthcare “Living the Mission” award.

In his personal time, Dr. González and his wife are active in church and youth development programs; the Fort Worth Hispanic Chamber of Commerce; Hispanic Women’s Network of Texas/Fort Worth Chapter; and are founders of the Gloria J. González Memorial Scholarship Fund for the Advancement of Latinos in the Healthcare Professions, honoring his younger sister who was killed in a car accident before realizing her dream of becoming a pediatrician.

Posted Date: December 12, 2018

By Sally Crocker

Apha 2018


UNTHSC School of Public Health (SPH) students, faculty and alumni participated in a variety of educational workshops and had opportunity to network at dinners and other events as part of this year’s American Public Health Association (APHA) Annual Meeting and Expo in San Diego.

More than 13,000 public health professionals from across the country took part in this four-day conference, held November 11-14, focused on the theme of “Creating the Healthiest Nation: Health Equity Now.”

Breakout sessions covered topics including chronic disease management; infectious disease prevention; environment and food safety; health reform; maternal and child health, with a special focus on the role of fathers and partners; and other key determinants of building a healthier population.

FullsizerenderUNTHSC Public Health Student Government Association (PHSGA) President Luvleen Dharni and PHSGA Vice President Sarah Matthes were selected to represent the SPH at the Student Leadership Institute (SLI) led during the conference by the Association of Schools and Programs of Public Health (ASPPH). The SLI is a skill-building and networking opportunity for student leaders at ASPPH-member institutions.

Other UNTHSC students attended the APHA conference as well, with travel scholarships provided by the SPH and PHSGA.

“Attending this conference gave me a great opportunity to network and learn more about the importance of advocacy in the field of public health,” Dharni said. “I was surrounded by people who value public health and understand the impact we make at the population level. I looked forward to returning to campus to work with the student body in taking small steps to help build the healthiest Tarrant County community.”

During the trip, Dharni and other participants were also involved in two Public Health Service Day volunteer events, to help clean up San Diego’s Embarcadero Beach and Promenade, and to give time to a non-profit agency’s thrift boutique dedicated to child abuse prevention and building family resilience.

The most memorable breakout session for Dharni featured a panel presentation on “Dying Too Soon,” looking into critical issues surrounding the premature deaths of women in the U.S.

For Matthes, the opportunity to take part in SLI, to learn from experts on cultural humility and writing as a public health tool, and to interact with student leaders from other universities and programs was especially important.

Apha A2018“I came away from APHA having met inspiring individuals and having learned novel approaches for addressing public health concerns,” Matthes said.

Dr. Dennis Thombs, SPH Dean, said this year’s annual meeting also gave faculty and alumni a chance to reconnect, as well as to participate in various breakout sessions and presentations, gain new insight and collaborate with other schools, researchers and industry leaders.

“It’s an important experience for our students and a great way to join with our colleagues on a national level in exploring new solutions to some of public health’s greatest challenges,” he said.

The 2019 APHA Annual Meeting is scheduled for November 2-6 in Philadelphia, with the theme of “Creating the Healthiest Nation: For Science. For Action. For Health.”

Posted Date: November 26, 2018

By Sally Crocker

Thad Miller Systems Thinking Seminar 1Thought leaders from around the country recently joined forces at UNT Health Science Center to brainstorm on new approaches for controlling an ages old health risk.

“A century ago, my grandmother lost her sister, mother and grandfather to tuberculosis,” said Dr. Thaddeus Miller, UNTHSC School of Public Health (SPH) Associate Professor and Principal Investigator of the North Texas Tuberculosis Epidemiologic Studies Consortium (TBESC), one of the CDC’s 10 such selected TB research sites in the U.S. “Through rigorous domestic public health programs, including a focus on latent TB cases, the United States has been largely protected in recent decades. But this protection, as well as new and emerging threats, shouldn’t be taken for granted until we are able to see TB only in our past and not our future.”

Leaders from the CDC’s Division of Tuberculosis Elimination came together with partners from across the U.S. for a Systems Thinking Symposium with the goal of more effectively leveraging the U.S. commercial healthcare sector against the persistent threat of TB.  The day was an example of the power of interprofessional collaboration.

More than 30 participants brought perspectives representing academia and research, healthcare, state and federal health agency oversight, private and public provider organizations, the managed care industry and others.

Dr. Miller and colleague Dr. Erica Stockbridge, UNTHSC SPH Assistant Professor, led much of the event’s development and organization, with a much larger team from around the UNTHSC campus and beyond playing supporting roles.

Led by MHA student Kaitlyn McKinley, UNTHSC teams of public health, TCOM and pharmacy students provided hospitality and recorded the discussions.

Dr. Crystal Howell, School of Pharmacy Assistant Professor, contributed to the event’s development, and was among the several UNTHSC faculty who took a direct part in the day’s discussions.

Tarleton State University’s College of Health Science and Human Services also participated, contributing a team of faculty volunteers, led by associate Dean Dr. Julie Merriman, to moderate the discussions.

The topic of latent TB infection (LTBI) was of special interest at the event.  People can carry LTBI and not even know it, with the infection lying dormant for years or even decades.

Thad Miller Systems Thinking Seminar 2During this latent stage, TB is not infectious, has no symptoms and can’t be passed on to others, but it is estimated that anywhere from five to 10 percent of people with LTBI will develop active TB at some point in their lifetime, Dr. Miller said.  “This is especially concerning given CDC estimates that as many as 13 million people in the U.S. have LTBI,” he said. On a larger scale, about one-fourth of the world’s population has LTBI.

LTBI is more prevalent in certain countries, and states in the U.S. with high populations of foreign-born individuals, like Texas, California, New York and Florida, may be at higher risk for the potential of active TB among residents. Foreign-born populations account for nearly 70 percent of active TB cases in the U.S., and the LTBI prevalence is about 13 times higher among these groups.

“LTBI is treatable and can usually stop the development of active tuberculosis,” Dr. Miller said. “Public health officials and the CDC agree that to solve this problem, private sector health providers and influencers must be engaged, to work side by side with the public health system in testing and treatment.”

“The public health system does not have the capacity to address this alone,” said Dr. Thomas R. Navin, Chief of the CDC’s TB Surveillance, Epidemiology and Outbreak Investigations Branch, who opened the symposium at UNTHSC.

“TB-related care, including testing and treatment for LTBI, has historically been provided by local public health agencies,” Dr. Navin said, “but to more effectively address the slowing progress in TB elimination across the country, a new and expanded approach is needed to look beyond what public health, working on its own, can provide.”

The goal of the symposium was to engage participants in multifaceted thinking, to look at new ways of addressing this major health challenge together on a broader scale, Dr. Miller said, and to identify both long-term and more immediate actions that can be taken now.

“By enlisting help from other stakeholders who impact care, insurance, regulatory and quality compliance, medical testing, bottom-line coding and billing, research and policy, we stand a better chance of stopping TB,” Dr. Miller said.   “Without taking new action to finish the job we’ve begun, we run the risk of a future as ravaged by TB as was our past. I’m proud to be part an organization with the partnerships and expertise to see this fight to the end.”

Posted Date: October 9, 2018

By Sally Crocker

Wagner Teresa Hero Award

Dr. Teresa Wagner, right

Dr. Teresa Wagner’s own experiences as a mother trying to help her daughters through two life-threatening health scares, misdiagnosis and providers’ failure to recognize critical symptoms ignited her passion to lead the charge for improved patient health literacy and better communication between physicians and patients across Texas.

In recognition of her efforts to bring about change in the ways people navigate and understand today’s complex healthcare environment, Dr. Wagner has been named as the 2018 Health Literacy Hero by the Health Literacy Collaborative, a network of healthcare professionals, educators, businesses and community members working for improvement and increased awareness of health literacy.

The award was presented at the partnership’s 14th Annual Texas Health Literacy Conference in San Antonio.

Dr. Wagner is Assistant Professor of Health Behavior and Health Systems at the UNT Health Science Center School of Public Health and serves as Senior Fellow for Health Literacy at the UNTHSC Institute for Patient Safety.

She remembers the struggles her older daughter, then in college and living away from home, went through before it was finally discovered that she had appendicitis.

“The symptoms were getting worse; my daughter knew that what she was feeling wasn’t right, yet the physician continued to say it was something else, not that serious,” Dr. Wagner said. “Years later, at 27, she went through a similar situation with diverticulitis.”

Dr. Wagner’s younger daughter sought care for a different problem but ended up silently suffering in pain from an undiagnosed hormonal syndrome, after deciding not to go back to the physician who had told her the only thing wrong was that she needed to lose weight.

“When someone feels shamed, or that they are just not being listened to, they can end up living with symptoms that are often debilitating or even deadly,” Dr. Wagner said.

Age-related disparities can have a profound impact on health literacy, she said, with the most vulnerable populations being young people just learning to live on their own, roughly ages 18 to 23, and senior adults, who may be too frail or too ill to speak up for their own care.

Solutions point to a give-and-take relationship and clear, open, two-way communications between patients and their health providers, both in person and in the directions and medications provided.

“There are many facets to health literacy,” Dr. Wagner said. “Consider the pages and pages of discharge paperwork that patients receive when leaving the hospital. If patients have trouble understanding what they should do when they get home, the repercussions could be critical. Prescriptions, as well as recommendations sent home after a clinic or physician’s office visit, represent other good examples where instructions might be confusing. Revising these types of materials into plain language can make a real difference.”

As the result of a policy brief Dr. Wagner developed for the State Health Committee and her testimony during  the 2017 Texas legislative session, state leaders will be reviewing recommendations for improved health literacy actions in the 2019 legislative session.

“Five other states now have legislation, and others have centers dedicated to health literacy. The hope is that Texas will move forward in this direction as well,” she said.

Dr. Wagner’s current research interviewing administrators and leaders representing up to 80 different healthcare organizations across North Texas is giving her a unique opportunity to examine the health literacy challenges that exist in hospitals today, based on the National Academy of Medicine’s model for Attributes of a Health Literate Organization.

Through the study, each participating hospital will receive a report on the strengths and opportunities of their organization, as well as recommendations, training options and areas for collaborative health literacy efforts across healthcare systems.

Dr. Wagner is also involved in research related to the impact of health literacy on maternal health, birth outcomes and postnatal care.

“As a mom who has been there, my hope is that no patient has to go through what my daughters have endured. The push for greater awareness and improvements in health literacy has the power to change and save lives,” she said.