Health Literacy: More than just knowing

Every October, we celebrate Health Literacy Month — a time to recognize the importance of making health information easy to understand and the health care system easier to navigate. A team of experts recently split the definition into two parts:

• Personal health literacy: The degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
• Organizational health literacy: The degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

Health literacy goes beyond the ability to read and comprehend medical pamphlets or follow prescription instructions. It also includes one’s understanding of preventive measures, ability to navigate the complex healthcare system, and make informed decisions about one's health. Health literacy is a fluid state that doesn't depend on a person's education level or reading aptitude. Often, when people encounter a medical emergency, their health literacy is lowered due to the shock, emotion, and stress of their situation.  In the digital era, where telemedicine and virtual consultations are becoming the norm, the gap is widening between those who are proficient in health literacy and those who are not. Healthcare executives can play a pivotal role in bridging this divide and are increasingly being called upon to do so. While personal health literacy estimates are varied, all research underscores the need for improved healthcare communication to ensure understanding. This work is a core component of person-centered cultural competency training. Health literacy describes a person's ability to obtain and understand the medical information needed to make informed healthcare decisions. This includes the ability to understand medical explanations of symptoms and illnesses, follow directions for medications, tests, and procedures, and ask relevant questions.

The consequences of low health literacy can be far-reaching, affecting patient outcomes, healthcare system efficiency, and healthcare costs. We can define health literacy as the capability of an individual to obtain, interpret, and comprehend necessary medical information to make sound healthcare decisions. This encompasses:

• Understanding medical descriptions of symptoms and diseases
• Following instructions for medications, tests, and medical procedures
• Completing health-related forms
• Efficiently navigating healthcare services
• Assessing risks and benefits
• Managing chronic diseases

Unfortunately, about 90 million American adults don't possess adequate health literacy skills to use the healthcare system to its fullest potential effectively. Low health literacy disproportionately affects marginalized groups, including minorities, older people, and those with chronic ailments. Often, these individuals turn to friends and family for health advice. While this might offer some help and comfort, it exposes them to misinformation and potentially harmful beliefs that might conflict with expert medical advice. Several studies highlight that those with lower health literacy frequently experience miscommunication with healthcare professionals. Some might hide their confusion due to embarrassment, while others might not even realize they've misunderstood crucial information. Consequently, this group often harbors feelings of skepticism, mistrust, and dissatisfaction with healthcare services. The ramifications of poor health literacy are undeniable. Individuals with low health literacy often face the following:

• Higher chances of non-compliance with treatment plans
• Increased risk of preventable hospital admissions

From an economic standpoint, the cost of these misunderstandings can be staggering. Estimates suggest that the financial toll on the healthcare system due to inadequate health literacy ranges from $106 billion to $238 billion annually. Considering the grave repercussions, healthcare professionals must adopt strategies to communicate effectively with those with limited health literacy. Here are some best practices:

• Speak at a moderate pace, ensuring clarity
• Use plain language, sidestepping medical jargon and complex terms
• Share information in manageable chunks, reiterating key points
• Encourage patients to paraphrase what they've understood to confirm comprehension
• Foster an open, non-judgmental environment that prompts questions and discussion

While only 12% of American adults are considered to have very high health literacy skills, it's vital to understand that health literacy isn't solely determined by one's general literacy, education, or age. High-stress situations, like a medical emergency, can impede anyone's processing of complex health information. Therefore, healthcare professionals should begin every medical conversation with the presumption that there might be gaps in the patient's health literacy.

Health literacy is integral to ensuring patients actively participate in their healthcare journey. It's essential to define health literacy and understand the widespread impact of low health literacy. By recognizing the significance and tailoring communication strategies, healthcare professionals can bridge the knowledge gap, leading to better patient outcomes and a more efficient healthcare system. As we observe Health Literacy Awareness Month, let's commit to prioritizing health literacy and cultural competency in healthcare. Together, we can ensure a healthcare system that is inclusive, equitable, and delivers the highest standard of care to all.