Introduction
Almost 90% of adults in the United States struggle with health literacy.Personal health literacy is an individual’s ability to understand and use information to make well-informed healthcare decisions. It goes hand in hand with organizational health literacy, which focuses on the responsibility organizations have to individuals. Healthcare information and service providers have a duty to help promote healthcare literacy, as inequities can exacerbate existing disparities. Without adequate knowledge and background understanding, patients cannot advocate for themselves or properly make decisions regarding their health.
Disparities in Health Literacy
According to the World Health Organization, health literacy is associated with numerous other social determinants of health. These include age, gender, education level, race, income, and more. Such factors can greatly impact an individual’s ability to access and understand health information. One study from Health Literacy Research and Practice found that income and education had the biggest impact on disparities- about 30% and 37% respectively. These struggles can arise for a myriad of reasons, such as lack of familiarity with medical terminology, difficulty interpreting risk and statistics, or stress due to a new diagnosis.
A lack of healthcare literacy is associated with worse outcomes as well. Research demonstrates that limitations in knowledge and understanding are associated with a higher burden of disease, particularly chronic diseases. Without adequate literacy, misunderstandings and unintentional nonadherance become far more common.
Connection to Chronic Disease
Health literacy is especially important for patients dealing with chronic illnesses. One study from MDPI reviewed the existing literature to examine existing approaches. They found that educational interventions from nurses were essential to improving chronic disease self-care outcomes. Increased literacy improves the quality of chronic disease treatment and improves patient adherence, knowledge, and behavior.
Another meta-analysis from Patient Education and Counseling looked at challenges associated with health literacy interventions. The researchers noted that these interventions were less effective amongst older adults with chronic diseases, suggesting that alternative types of interventions may be necessary for this population. This could be due to lack of technological skills, unwillingness to change their attitude, or decreased cognitive abilities. They also discovered that the efficacy of health interventions varied across disease, meaning that other contextual factors may be at play. For conditions such as diabetes and hypertension, these interventions were more effective than less common diseases like COPD.
These challenges highlight the importance of modifying interventions to fit the audience. Health literacy is critical for all patients, but there is no one intervention that will equitably help all populations. The key thing to consider is what changes need to be made if an intervention is not effective for a particular group.
Improving Health Literacy
Personal health literacy can be improved by providing better education for children throughout their schooling. Moreover, increasing personal health literacy is directly tied to organizational health literacy. Providers, insurance companies, and public health organizations all have a responsibility to ensure that they are disseminating information in a way that is actually accessible to the people they are trying to reach. This can include:
- Tailoring health promotional materials to specific demographics (e.g. app-based communication may not be the best for older adults)
- Avoiding esoteric medical terminology
- Considering linguistic and cultural barriers
- Taking the time to address a patient’s questions or concerns
- Providing resources for additional research and information
Ensuring that people are receiving all of the information they need in a format that they are receptive to is an important step to helping them feel like their voices are being heard. Empowered patients are more likely to feel confident in their medical decisions and feel prepared to speak up about their needs. This is beneficial for patients as well as the health system, increasing efficiency and reducing costs for all.
Conclusion
Improving personal health literacy is vital to mitigating disparities. For people with chronic diseases, it is of even more importance. Understanding health information and being able to make well-informed decisions enables chronically ill patients to take charge of their own health and advocate for themselves.