Levels of Health Literacy

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Today in society there are a lot of health issues that have gone untreated or have gotten much worser as a result of limited or lack of health literacy but what exactly is health literacy? and why is it so important when it comes to our health? Health literacy is important because it is the ability to be able to comprehend certain health information so that a person can make the best-informed decisions pertaining to their health. “Health literacy is linked to literacy and entails people's knowledge, motivation, and competence to access, understand, appraise and apply health information in order to make judgments and take decisions in everyday life concerning healthcare, disease prevention, and health promotion to maintain or improve quality of life during the life course of a person.

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” (Sorensen et al., 2012, p. 3).

When talking about health literacy it is important to have a base understanding of 3 levels that health literacy is composed of those being basic, communicative and critical.

Basic health literacy entails understanding the fundamentals of reading and writing. A person with basic health literacy is capable of reading and writing but has limited knowledge of their health. He or she might not understand simple medical terms such as referrals or what underlining health conditions means. This often results in the provider asking more questions to ensure that they are both on the same page. Then, we have people with interactive health literacy this entails having the basic skills while also possessing advanced cognitive skills. People who have this level of health literacy have a different approach and lean more towards self-help.

The individual’s behavior may be more intuited with his health, this is important because the attitude you have towards your health can ultimately benefit you or create challenges for you. If a person is more engaged in wanting to get better, he or she will make the effort to seek out treatment and follow through with their treatment plan. This is the same concept a person who has a negative outlook towards their health they are probably less likely to seek out treatment or be as engaged and will often use mechanism such as self-blame as to why they are sick or be in denial when it comes to their health. Then, we have critical health literacy this entails the use of critical thinking skills people with this level of health literacy can analyze their options while possessing the skills of basic and interactive combined. An individual who has critical health literacy is most likely to stay on top of their health such as going to the doctor annually to get check-out or going to the doctor when they become sick. They have an understanding about the importance of their health and can optimize health options to help improve their quality of life.

Although a significant proportion of the general population has low health literacy, certain groups have an even higher prevalence of the problem. “Such groups include the elderly, minorities, individuals who have not completed high school, adults who spoke a language other than English before starting school.12 A study conducted by the NAAL demonstrated a higher prevalence of poor health literacy among the elderly. This was compared with the 36 percent of all adults who scored in the bottom two categories on the NAAL survey, 59 percent of adults age 65 and older scored in the “below basic” and “basic” range.12 This association between age and health literacy has proven consistent in other studies of literacy in health care settings.” (Sentell, T., & Braun, K. L. (2012).

In addition, important factors that play into low health literacy should also be addressed. Social determinants for instance the economic and social condition of a person plays a significant role in their overall health. Prime examples include the area where in where a person lives, living in an impoverished area can put a definitive constraint on a person’s health and education. When comparing a suburban area versus an urban area we show a higher percentile of people who show a lower level health literacy in the urban area versus the suburban area.

Furthermore, barriers like access to healthcare, can also lead to difficulties in obtaining preventive care. Since literacy is fundamental in everyday life, we can infer that people with limited education will face challenges that could impact their health. Let’s say that you are the doctor because you are sick and have had a prolonged cough that does not seem to go away. Upon arriving at the doctor’s office, you will need to complete the new patient paperwork, this alone requires you to have a basic level of reading and writing. This will be difficult for the individual because he or she will struggle to fill out important information that can implicate the overall outcome of their treatment plan. Important information that could be asked can include if the patient has any underlining conditions, or is the patient on any current medications, and is the patient aware of any allergies. This is important information that the health provider should be aware of as his or her job is to make an accurate diagnosis and prescribe medications that won’t worsen the patient’s health or cause an adverse reaction. In addition, the patient could also have a hard time reading and understanding the treatment plan. Therefore, he or she will most likely not be engaged with asking questions pertaining to their health since they are unable to fully understand. Ultimately, this results in the patient to go to the doctor but receive zero benefits because the patient is likely to not comply with the treatment plan that was offered.

Now let’s say we switch the roles and the patient has a higher level of health literacy he or she will not find it difficult to fill it out the new patient paperwork. In addition, they will show more engagement in asking questions such as, how can I prevent getting this? Or what do you recommend for me to take? or is there any restrictions when I’m taking this medication? This is actively showing that the patient wants to know their options and wants to be informed on the diagnosis and the different methods he or she can take to improve their health. These types of patients will most likely follow their treatment plan without any difficulties because they understand the importance in their health so that they are able to make the best-informed decisions when it comes to their overall health. It is imperative to say that health literacy is fundamental to the outcome of a patient’s health.

Now that we have a better understanding of what health literacy is, how can we improve health literacy? For starters we would need to strengthen our focus in patient education. A healthcare professional should always make initiative to ask the patient questions. As well as minimizing the use of medical terminology and simplifying those terms can be beneficial to the patient. Most times patients will not understand certain words but simplifying terms to a level that the patient is able to grasp the information can aid towards informed decision making. In addition, to all of this it is significant to explain the importance of the patient’s treatment plan regardless of the severity of their condition, a health care provider should always inform and explain. Adding urgency to the matter can create a sense of importance so that they follow through with their treatment plan regardless if the condition is acute or chronic. It is always important to motivate them so that they are compliant. A health care provider should always confirm with the patient if they understood their options confirming eliminates uncertainty and lets you know that everyone is on the same page. What are other things can health care providers could do to improve health literacy? When asking the patients questions try using open ended questions this allows the patient to convey more while also helping the health care professional get important information to make a diagnosis communicating is key.

Health care professional should abstain from using scare tactics like the authoritarian approach, meaning they will use intimidation by using their title to belittle patients such as I am the doctor and I know more than you. This method is not recommended patients can get a wrong impression and will more likely go somewhere else for treatment or not return. Having empathy is required to an extend if the patient feels like the health care professional is concerned the patient is more willing to open up and be a little bit more comfortable with the health care professional.

In conjunction with patient education a health care professional should also possess skills and methods in how to treat, educate, and train patients to follow through in what they need to while also ensuring patient compliance and strengthening health literacy. For instance, using a centered care approach meaning putting the individual patient first. Patient-centered approach to health care has shown an increased patient satisfaction and better health outcomes. It is the health care professional responsibility to initiate everything as mentioned earlier this includes greeting the patient and asking questions. This removes the pressure of initiating the conversation from the patient and allows him or her to be more talkative when questions are being directed towards them. Patients are more engaged in listening and can understand better which ultimately results in beneficial gain in health literacy. When using this approach, patients are treated as partners, and they are fully informed about health-related matters. Patients are better informed and more involved in treatment planning and decision making and are encouraged to accept more responsibility for their health care.

In addition, a health care provider should always use observational and active listening skills these are important and required in further treatment, because you are required to have the skills to see if the patient is progressing or not by visually looking at them because often times patients don’t explain everything or could say they understand but actually not.

In order to be able to strengthen health literacy, we must train patients in order to use the information we are giving them without that you are not going to see no progress. Instead of dumping a lot of information on patients try breaking down the information into manageable parts for that patient. If you approach things this way you can get indication on that patient and then they are able to grasp the information more quickly than someone else and understand where the parts are leading. Including sequence can help certain patients with allowing them to be able to know direct indication on how to go about certain treatments. These are things many health care professionals don’t ask or even consider such as social support of the patient these are things that can impact a patient’s treatment plan. If you take this into consideration you can be able to tailor a patient’s treatment plan, and this can be beneficial to compliance.

As mentioned earlier there are a lot of issues that stem from poor health literacy. The impact of having a low level of health literacy can create financial burdens in preventable health problems. According to Healthy People 2020 “This is likely to increase long-term costs of chronic diseases resulting from behaviors begun during adolescence and young adulthood regarding their health.” Risk that can arise from low literacy include complications in current illness, increased risks of hospitalizations, morbidity, and mortality. As a result, more spreading of diseases can happen leading to a society of more sick people at a rapid pace increasing day by day. Health literacy not only affects the health of the individual, but it puts a strain in our economy and the health of others too. As mentioned before most people who have low health literacy come from poverty-stricken areas. These people are more likely to have a dependency towards state and federal funded programs. However, because of current barriers that they already face they are more likely to not utilize the benefits because of lack or limited sources in their area. Therefore, making it harder for them to obtain basic preventative health care. This ultimately results in intentional self-neglect causing patients to carelessly put a hold on their health because they aren’t sick enough, or they are not in enough pain. Unfortunately, they are later faced with the overprized cost in medical care because their health worsened, and more intervention is needed to stabilize their health. Now taxpayers are faced with the financial burden of having to continuously pour money into these state funded programs that often go unused while the cost of debt continues to grow.

According to the Affordable Care Act (ACA) “More low‐income adults are eligible for health insurance through expanded Medicaid or the Health Insurance Marketplace.” However, choosing the right health insurance plan and knowing how to use it can be challenging. Factors such as poverty, gender, low health literacy, and a lack of previous health insurance coverage impacts an individual's ability to interpret health insurance terminology and choose plans (Janiak, Rhodes, & Foster, 2013). For example, in a national survey 50% of respondents did not know what the health care exchange was and 42% could not define a deductible (Barcellos et al., 2014). Only 10% of low‐income Americans who were eligible for the Medicaid expansion felt like they had adequate information to make a decision about health insurance coverage (Politi et al., 2014). Aside from the challenges of choosing a health insurance plan, many insured adults do not know how to use their health insurance coverage and face barriers finding medical providers, predicting costs, and navigating the healthcare system (Bell et al., 2017; Lopez, 2005).

Ongoing shifts in health policy and implementation of the Affordable Care Act in the United States further highlight the importance of these critical questions. Individuals newly eligible for publicly funded or subsidized health insurance will need to navigate the system to find accurate and usable information; to be able to apply these concepts to their existing or anticipated health situation to select the most appropriate plan. All those steps must occur before an actual visit with a health care professional. In short, advancing health literacy is important and necessary because a fully engaged, health literate public with the skills necessary to perform a variety of increasingly complex tasks and health behaviors will be vital to optimizing both individual and public health. (Pleasant A. (2014).

Health literacy greatly affects different areas in a person’s life from a financial aspect to the overall health of that person and unfortunately that impact is also felt today in society. It is important to address the disfunction that stem from low health literacy. By analyzing all internal and external levels we can help tackle this issue, while also using different methods to improve health literacy through patient education or even if it’s by educating one another.

It is bias to say those who come from disadvantage backgrounds will immediately be health literate this is not realistic; change will not happen overnight. Change will be slow but focusing on the foundation such as improving certain geographical areas by adding more health care services and removing those barriers one at a time can contribute towards healthier communities. In addition, people should also take initiative in wanting to learn and staying informed about available resources and the importance about their health. This behavioral approach aids in self-help in wanting to take those steps to stay healthy. Furthermore, health care professionals are also responsible to take action by using different methods to ensure their patients are informed and show compliance with their treatment. In doing so we’re taking responsibility as a team to come together and make that change happen.