Health Fair on Faith

This week will see the beginning of the Kentucky State Fair. This is paralleled by similar events in almost all U.S. states, designed to celebrate the importance of agriculture and to sell stuff. The Kentucky State Fair has a huge array of farm-related exhibits, including competitions for all types of animals and birds, equipment displays, rural food and craft exhibits and contests, and many other things totally unrelated to agriculture, but using the event as a marketing opportunity to reach the masses of people attending.

The Kentucky Department of Public Health is a principle sponsor of an area called Health Horizons. Other reputable organizations also participate, such as AARP, Anthem Blue Cross, and Walgreen's. In this exhibit, various screening services will be offered, including blood pressure, skin cancer, oral health and prostate screening, bone density testing, body fat analysis, lung capacity assessment, and several other modes of screening. I don’t know all of the organizational structure behind this effort, but I’m hoping they do more than just test.

In addition to the health screening, Health Horizons and another Exhibits area will have nonprofit and for profit vendors distributing all kinds of health information and selling many health-related products and services. Some of these exhibits will provide useful information. Others are well-meaning but misguided, and still others are knowingly perpetrating fraud. All that is required to be an exhibitor is to apply for booth space, pay the fee, and not be requesting an exhibit place to promote something illegal or severely violating community standards.

For perhaps the last 30 years, the health fair has become institutionalized as a common method of health promotion. The jury is mostly in on health fairs and the verdict is not encouraging. There seems to be a lot of confusion and muddled practice when communities and organizations want to mount these events.

If you are thinking about organizing a health fair, there are two basic questions you should answer. First, what do you want to achieve? Second, how will you know if you succeeded? Without good answers, you might get a news story in the back pages of the paper, but probably will have no impact on the public’s health.

If the health fair is going to feature health information, how are you engaging people in the information and is there a connection to other strategies to help people make changes? Information alone is almost never sufficient to change health-related lifestyles. Just because someone sits in a booth and gives away 1,000 brochures on nutrition does not mean that anyone’s diet and health actually improved.  There may have been more impact on the health of trees.

If the health fair includes screening, it is only effective if there is an infrastructure in place. What will happen with the results? Who will interpret the results to the persons screened? Do those persons have access to further assessment testing if screening results are positive? Is there someone who will work with a person to promote indicated lifestyle changes such as weight loss, dietary change, or smoking cessation? If these things are not part of the plan, such isolated screening may be health promotion malpractice.

Finally, if the health fair is open to any individuals and groups who want to pay for space to market health-related products and services, there should be evidence-based guidelines which determine acceptance, not just the ability to pay. Health promotion workers and sponsors of health fairs have an ethical obligation to the public, assuring that information distributed at the fair is true and that products and claims from vendors are based on legitimate medical evidence. Unfortunately, this is not the case at the KY State Fair, though in defense, decisions are not made by public health and health promotion professionals, but by those with more interest in business development and making the Fair profitable.

The U.S. is a pluralistic society in which freedom and diversity of speech and ideas are cherished. Still, at least in the health promotion spaces we control, the buyer should not have to beware.