At some point nearly every person will be tasked with listening to and processing medical information to make health-related decisions. Whether that be deciding to get a vaccine, take a medication, have a surgery or procedure, or initiate palliative care. Health information is presented to people in the news daily, but how well are most people able to process health-related information to make informed decisions? In other words, what is the average level of health literacy?
What is health literacy and how does it affect health?
Health literacy is the ability to find, comprehend, and use information and services to make health-related decisions. Low health literacy may lead to poorer health outcomes such as improper medication use, reduced uptake of preventive health care such as screenings and immunizations, increased health anxiety and depression, and even increased mortality. Lower health literacy is associated with smoking and substance misuse, sedentary lifestyle, higher body-mass index, and other health risks. Higher health literacy seems to empower patients to take a more active role in medical decision making and this may prevent polypharmacy and other inappropriate prescribing as well as reduce misdiagnosis and overtreatment.
Who is affected by low health literacy and what causes it?
Over one-third of people in the United States are estimated to have low health literacy. Some populations may disproportionately be affected, such as people with lower socioeconomic status, older adults, those with lower education, Black persons, and Hispanic persons. But anyone of any race, ethnicity, age, or social class may have low health literacy. Low health literacy can be due to a variety of reasons including cultural and communication barriers or poor explanation of information from health care providers. Even if a person has strong literary skills outside of a clinical setting, they may be unfamiliar with the clinical terminology or concepts discussed, scared of the information presented, or be expected to follow complex self-care regimens that are difficult to understand and follow.
How can health literacy be improved?
- Use plain language, visual aids, culturally appropriate terms and clear instructions. Be an active listener, using the “teach-back” method and encouraging questions.
- Create individualized care plans based on the patient’s health literacy to achieve their health goals, including use of tools such as pill organizers or simple guided instructions for at-home care.
- Be cognizant of the patient’s ability to access and use technology when recommending digital resources such as webpages or apps.
- Train yourself! The Centers for Disease Control and Prevention (CDC) provides free online CME training here and links to several other organizations providing training here.
Humble respect for patient and caregiver’s lived experience, opinions, and input can result in more effective communication and care, improving long term outcomes.
