Health literacy

What is Health Literacy?

Health literacy can be defined as the capability of patients/clients/people to understand information about health and health care, and their ability to use this information to make decisions and protect their health.

Advantage of Health Literacy
  • Most patients return home without understanding all information what doctors told them in their appointments.
  • Health literate patients or clients can make healthy lifestyle choices, efficiently communicate with health care providers and access information and services.
  • Clients who have nil or low health literacy suffer from different diseases and poor health conditions.
  • Health literacy becomes more significant issue when people become old and get more chronic disease.
  • Health literacy helps to promote effective communication among patients/clients/families and doctors.
  • They become capable to give and receive, interpret and act on information such as treatment options and plans.
  • Health literacy has very promising, vital and evolving ideas (AIHW, 2022).
Scenario of Global Health Literacy
  • 60% of Canadians over the age of 16, and 88% of seniors have low health literacy (VCH PrimaryCare, 2023).
  • In Australia, 60% of people have low health literacy ((CEC, NSW health system, 2023).
  • The National Assessment of Adult Literacy (NAAL) conducted in 2003 demonstrated that only 12% of American adults had high levels of health literacy. 
  • The very recent survey conducted in Ireland showed that 21.3% of their people have “excellent” health literacy, 38.7% have “sufficient” health literacy while 40% have “problematic” or “inadequate” levels of health literacy (McHugh et al., 2022).
Types of Health Literacy

Health literacy has two aspects. Based on these aspects, health literacy is separated into two parts: (1) Individual health literacy, and (2) Health literacy environment. 

What is individual health literacy?

Individual health literacy is the skills, knowledge, motivation and capacity of a person to access, understand, appraise and apply information to make effective decisions about health and health care and take appropriate action.

What is health literacy environment? 

Health literacy environment is the infrastructure, policies, processes, materials, people and relationships that make up the health system and have an impact on the way that people access, understand, appraise and apply health-related information and services (AIHW, 2022).

How can health literacy be improved?

Health literacy plays vital role to make effective partnerships among patients, families and doctors which can improve the health of people.

  • Therefore, different countries have proposed their own national level actions and plans. These actions should be implemented within the health care system to improve health literacy levels among the people. The health literacy actions, plans and interventions can be implemented at the local, communities and national level health care systems.
  • Proper understanding and managing of health by the patients, families and carers can protect their health, improve the quality of their life and reduce the impact of disease and costs of care (CEC, NSW health system, 2023).
New Definitions of Health Literacy

Literature survey shows different types of definitions for health literacy with no consensus on its meaning (Sørensen et al. 2012).

Health literacy was newly defined in August 2020 after the U.S. government’s Healthy People 2030 initiative was released.

The updated definition addressed personal health literacy and organizational health literacy as below (CDC, 2023):

Personal health literacy is 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 is 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.

The current definitions differ slightly from the previous health literacy definition used in Healthy People 2010 and Healthy People 2020 (CDC, 2023):  

“the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

The new definition of health literacy added some new criteria of health literacy.

It added: not only understand the health literacy, but also use it and act on it. 

Making well-informed health-related decisions and actions for themselves and others rather than “appropriate” ones.

Taking Action to Improve Health Literacy
  • Not only Individuals, but also organizations, and communities have responsibility to improve health literacy.
  • Therefore, collaborative work of individuals, organizations, and communities can accelerate the improvement of health literacy.
  • Businesses, educators, community leaders, government agencies, health insurers, healthcare providers, the media, and many other organizations and individuals all have a part to play in improving health literacy in our society.
Measurement of Health Literacy
  • Measurement of health literacy will produce data which can help health policy makers and health organisations to make decisions and provide health services suitable and appropriate for different segment of people (AIHW, 2022).
  • The Organisation for Economic Co-operation and Development (OECD) emphasized that finding out the appropriate method of measuring health literacy can remove barriers to health literacy and improve the percent of health literacy in the people (Moreira 2018).

Currently, it is hard to measure health literacy due to following reasons:

  • Broad range of definitions of health literacy,
  • No confirmed agreement to decide what to measure,
  • Now different approaches are used to measure it (Osborne et al., 2013; Poureslami et al., 2017).
Further Actions

Therefore, we need to come to consensus on

  • Definitions of health literacy.
  • What factors should be included in measurement of health literacy.
  • Unique approach to measure health literacy.

References

Australian Institute of Health and Welfare (AIHW), 2022. Health literacy, Release Date: 07 Jul 2022. URL: https://www.aihw.gov.au/reports/australias-health/health-literacy.

Centres for Disease Control and Prevention (CDC). Health Literacy. URL: https://www.cdc.gov/healthliteracy/learn/index.html#print. Accessed on 05/02/2023.

Clinical Excellence Commission (CEC), Health literacy, NSW health system, NSW Government. URL: https://www.cec.health.nsw.gov.au/improve-quality/teamwork-culture-pcc/person-centred-care/health-literacy. Accessed on 05/02/2023.

McHugh M., Hayes S., Tajber L., Ryan L., 2022. Medicine Maker: An Outreach Activity for Pharmaceutical Manufacturing and Health Literacy. J. Chem. Educ. 99, 3, 1231–1237.

Osborne RH, Batterham RW, Elsworth GR, Hawkins M, Buchbinder R., 2013. ‘The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ)’, BMC Public Health, 13:658.

Poureslami I, Nimmon L, Rootman I, Fitzgerald MJ., 2017. Priorities for action: recommendations from an international roundtable on health literacy and chronic disease management- external site opens in new window, Health Promotion International, 32:743–754.

Sørensen K, van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H and (HLS-EU) Consortium Health Literacy Project European (2012) ‘Health literacy and public health: a systematic review and integration of definitions and models’, BMC Public Health, 12:80.

VCH PrimaryCare, 2023. URL: https://www.youtube.com/watch?v=_8w9kdcRgsI