Health literacy is defined as a person’s ability to obtain, process and understand basic health information so they can make decisions for their health and the health of others.³ Whether explaining the importance of maintaining a proper septic system or food safety protocols, helping patients understand the importance of a healthy diet or explaining infectious disease mitigation measures, the health literacy of individuals is a critical factor in our work.

Why Is Health Literacy Critical?

When people have access to accurate, easy-to-use information, they can protect and promote their health by adopting healthy behaviors and following recommendations. Low health literacy is frequently associated with other social and economic factors that reinforce health inequities.⁶ It results in lower adherence to preventive behaviors, weaker compliance with health interventions, and poor self-care.⁶

Elements of Health Literacy

There are several important elements of health literacy that impact how people process health-related information:

• Reading level: In the U.S., 54% of adults between the ages of 16 and 74 years old read at the sixth-grade level or below.¹ This presents a significant challenge to an individual’s ability to understand written information about health.
• Numeracy: Numeracy refers to mathematical skills necessary to understand and act on essential information.² This includes things such as nutrition information, blood pressure readings, medication dosage and understanding health risks. Interpreting numerical health risks can be especially challenging.
• Personal discounting: Most people inherently believe the risk to themselves is lower than the risk to others when presented with risks about their health.³
• Stress: When people are in contact with health information, they may be feeling sick, nervous, or confused. This compromises their ability to process information.
• Media literacy: Media literacy refers to an individual’s ability to understand and critically evaluate messages received through various media channels, including digital, social, entertainment and traditional news media. Media literacy impacts their ability to determine which messages include reliable, accurate information and which do not.³
• Self-efficacy: Self-efficacy refers to our belief in our ability act on the information we have.³
• Culture and belief systems: The way people process information is mediated through their cultural context, including racial, ethnic, linguistics and geographical factors, as well as their value systems, religious beliefs, and group identification.³

What can you do?

Here are a few strategies you can use to make communications more effective.

• Reading level: Use active voice and clear, simple language at the 6th-grade reading level or lower for all written communication. MS Word provides the Flesch-Kincaid Grade Level (Turn on readability statistics: File – Options – Show Readability Statistics).³
• Written documentation: Use graphics to convey information and simple, bold headers as “road signs” to guide the reader through the document.³
• Numeracy: Communicate numerical information in the simplest way possible. For example, if medication must be taken 4 times per day, suggest specific times.⁴
• Personal Discounting: Express the risk of poor health outcomes in the most concrete way possible – avoid percentages and make examples to illustrate risk as realistic as possible.³
• Stress: Give people time to process information when presented in a context that is stressful, such as when they are hearing a negative diagnosis for themselves or a family member. Further reduce complexity of information if possible, and check to verify understanding.⁵
• Media Literacy: Maintain an awareness of health-related messaging that may be prevalent in popular media. Be prepared to “inoculate” people against those facts: acknowledge that misinformation may be circulating and pre-emptively refute it.³
• Self-efficacy: Present information in a way that is empowering, helping individuals clearly understand the path forward and how to get help to overcome barriers.
• Culture and Belief Systems: Understand your audience and tailor messages to their specific context wherever possible. Act as though everyone is at risk of misunderstanding information.
• English proficiency: Translate written information for people with limited English proficiency and use a translator for face-to-face and phone conversations. Language Line is available to all staff who may be in need of translation services.

Sources

1. https://nces.ed.gov/surveys/piaac/measure.asp?section=1&sub_section=3
2. https://www.cdc.gov/healthliteracy/learn/UnderstandingLiteracy.html
3. Evans, Douglas, Introduction to Health Communication. Accessed September 14, 2021.
4. https://www.cdc.gov/healthliteracy/index.html
5. https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/health-literacy
6. Coughlin SS, Vernon M, Hatzigeorgiou C, George V. Health Literacy, Social Determinants of Health, and Disease Prevention and Control. J Environ Health Sci. 2020;6(1):3061. Epub 2020 Dec 16. PMID: 33604453; PMCID: PMC7889072.