Health Literacy: Key for Managing Personal Health

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Health literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions [1]. Health literacy is important because it affects a individual’s ability to manage personal health: to navigate the healthcare system, share health history with healthcare providers, engage in self-care and manage chronic disease, and understand concepts such as probability and risk.

According to the National Assessment of Adult Literacy, over one-third of U.S. adults (36%) — 75 million people — have below basic or basic health literacy [2]. An independent study by the Institute of Medicine reports similar findings: 90 million people in the U.S. have difficulty understanding and using health information [3]. As a result of poor health literacy, patients often don’t understand instructions on prescription drug bottles and nutrition labels, have trouble acting on health-related news and announcements, and don’t know how to locate and access affordable healthcare for themselves and their children. This is important because low health literacy has been linked to higher rates of hospitalization and use of emergency services, and less frequent use of preventive services. Both of these outcomes are associated with higher healthcare costs. Moreover, there is a link between a mother’s literacy level and her children’s academic success.

The National Action Plan to Improve Health Literacy

The U.S. Department of Health and Human Services has a plan to increase health literacy. Unveiled in the spring of 2010, the National Action Plan to Improve Health Literacy seeks to engage individuals, families, professionals, policymakers, organizations and communities in a linked effort to improve health literacy [4]. The plan is based on the principles that everyone has the right to health information that helps them make informed decisions and health services should be delivered in ways that are understandable and beneficial to health, longevity, and quality of life.

The National Action Plan to Improve Health Literacy enumerates seven overarching goals and highest priority strategies that we should pursue to create a health literate society:

Develop and disseminate health and safety information that is accurate, accessible and actionable.
Promote changes in the healthcare system that improve health information, communication, informed decisionmaking, and access to health services.
Incorporate accurate, standards-based and developmentally appropriate health and science information and curricula in child care and education through the university level.
Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community.
Build partnerships with philanthropic, advocacy, academic, professional and other organizations and government agencies and work with them to develop guidance and change policies.
Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy.
Increase the dissemination and use of evidence-based health literacy practices and interventions.

Although older adults, racial and ethnic minorities, people with less than a high school degree or GED certificate, people with low income levels, non-native speakers of English, and people with compromised health status are most likely to experience low health literacy, anyone can be affected. However, nothing — not age, income, employment status, education level, and racial or ethnic group — affects health status more than literacy skills. Indeed, people with low health literacy often lack the ability to read or write well.

Low health literacy is linked to health disparities — population-specific differences in the presence of disease, health outcomes, or access to healthcare. Initiatives designed to reduce disparities and achieve healthcare equity were a major component of the 2010 Patient Protection and Affordable Care Act (PPACA) and are critical to achieving the objectives set forth in Healthy People 2020.

What can patients do?

When it comes to healthcare, what you don’t know can hurt you. The Ask Me 3 campaign, a health literacy program sponsored by the Partnership for Clear Health Communication at the National Patient Safety Foundation, promotes three simple but essential questions that patients should ask their providers in every healthcare interaction:

What is my main problem?
What do I need to do?
Why is it important for me to do this?

People who understand health instructions make fewer mistakes when taking medicine or preparing for a medical procedure. They may also get well sooner or be able to better manage a chronic health condition.