Problem of Public Health: Health Literacy

Can you identify with any of these statements? Have you ever gone to the doctor or seen the nurse and had trouble understanding what was said at the medical visit, or gotten confused about how to take a prescribed medication. Have you ever had problems with completing a complex health assessment questionnaire? If you answered yes to any of those statements or question, then there is a possibility you have some health literacy issues. Health literacy refers to personal characteristics and social resources needed for people to access, understand and use information to make decisions about their health (Brabers et al.

, 2018). Health literacy (HL) according to another article is the degree to which individuals have capacity to obtain, process, and understand basic health information and services (Aoki and Inoue, 2018).

Health literacy is a public health problem globally. Nobody really thinks about it as being a public health problem, but it is. Statics has shown that the majority of people have some level of healthy literacy problems.

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Everyday people are going to see health professionals and leaving those visits just as confused or still not fully understanding what the doctor or nurse has said. This is leaving these patients and their health problems in limbo. Patients are more and more expected to be in control of their health. Patients are expected to be involved in making important decisions about their health and their healthcare. The reason for this is because of the ethical necessary for proper patient involvement about their health. Studies have shown that it is also beneficial for patient to play a larger role in their healthcare.

Some of the benefits are the fact that it increases patient knowledge, it increases patient satisfaction with their treatment decisions, it reduces patient apprehension and patient will stick to their treatment plan better. In addition, providing patient care that is considerate, approachable, and have morals is a key component to good quality care.

The topic of this review is health literacy. In this article the author states, that good management of many health conditions are contributed to patients understanding relevant information about their health. Having better support to patients with health literacy issues can also have a positive influence on their health. This is the reason why better methods should be used to help patients with low health literacy. This sets the framework for worldwide measures to improve the communications between health care professional and patients. Health literacy has always been a major public health dilemma with over a third of Americans having difficulties understanding basic health information. A number of factors are related with health literacy and taking into consideration of rising healthcare costs, it is imperative that more assessment of ways to be aware of and diminish the impact of poor health literacy is necessary. Practical communication interventions with health professional, health organization and their patient can improve the care for people with low health literacy. Assessing patient’s health literacy is of increasing concern for researchers and practitioners, given rapidly accumulating evidence that health literacy is correlated with health-related measures (Rawson et al., 2018).

A large number of patients have health literacy issues, and many patients will not admit to having reading problems. The National Work Group on Literacy and Health (1998) warned health care professionals not to take for granted that they can recognize patients with health literacy problems. Research has shown that many health professionals rarely can identify patients with health literacy issues. Challenges and strategies to improve patient health literacy is the topic of this literature review. Reading this review, it reports that 90 million adult Americans lack the literacy skills to effectively function in the current health care environment and this number has significantly improved over the past 10 years.

Health Literacy is found in many different health care areas. Elderly patients, non-English speaking adults and low education level adults are the majority of people suffering from health literacy. Poor health literacy is prevalent and is linked with many patients with major health problems. The descriptive pathways for this connection are complex. The reason people with poor health problems are associated with low health literacy is because the inadequate communication between health professional and patients. Having a good solution like a patient communication center, and a clear communication technique have proven a better health outcome with low health literacy. Teach back methods, and reinforcement, understandable health educational resources, illustration charts, comprehensible medication labels, tailored self-management support programs, and creating shame-free medical environments can help save lives also with these patients. Health care professionals and health organizations are often oblivious of the extent of patient literacy, regardless of its important health implications. Healthcare providers have a tendency to misjudge their primary care patients’ health literacy level, and fail to recognize literacy as a risk factor for health outcomes. The author states there are a number of measures accessible to assess health literacy.

Having basic terminology is a necessary requirement for understanding and applying health information The two frequently used procedures of assessing health literacy are the Test of Functional Health Literacy in Adults (TOFHLA, or the short version S-TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). The two measures linked with one another and with various health-related measures. but, the administration methods for these measures have some limitations for use in clinical settings. The TOFHLA involves a written test that is self-administered and takes 22 minutes to complete; even though there is a shorter version, the S-TOFHLA, but it still usually takes roughly 7 minutes. The REALM only takes approximately 2 minutes to complete; nevertheless, it is not self-administered. The REALM consists of patients reading a list of words aloud, and a practitioner must be present to score accuracy.

The METER (Medical Term Recognition Test) is one of the newly developed, short, self-administered measures of health literacy. Patients are required to read a list of words and recognize which ones are real words. It takes 2 minutes to complete and was associated with the REALM test. A more up to date testing instrument, the Newest Vital Sign (NVS), has also been developed to assess health literacy levels. The NVS takes around 3 minutes to administer. The NVS assesses more than comprehension skills. It assesses math, reading, and abstract reasoning. The NVS uses an ice cream nutrition label that the patient could hold and evaluate. Then six questions based on that label are read verbally. If the patient got 4 or more correct answers, this signified adequate literacy. If the patient got 2 to 3 answers correct, that signified limited literacy is possible, and none to one answers were correct, that showed the patient most likely had limited health literacy. The NVS showed sensitivity for recognizing limited literacy and modest specificity. But the NVS test was less successful than the S-TOFHLA for predicting health outcomes.

Results and Conclusions

The authors of the review concluded that health care providers and health organizations should ask patients about their assurance to fill out medical forms, use of a stand-in person to help read health information, and their self-rated reading ability were all successful ways for acknowledging patients with limited health literacy. Testing for poor health literacy is easy and can be performed perfectly with one question. Health care professionals should be able to identify and react properly to patients with limited literacy, before testing for it. Out of the studies using different testing devices met the criteria for poor literacy. For identifying patients with poor or insignificant health literacy, asking one simple question, “How confident are you in filling out medical forms by yourself?” This question is related with an answer of “a little confident”, “not at all confident”, “somewhat confident”, and “quite a bit” or “extremely confident”.

A combination of screening questions and demographic information did not perform better than single item screening testing. The Newest Vital Sign was the most effective for ruling out inadequate or marginal health literacy, but drastically less practical than the single item measurement. The best quality of the Newest Vital Sign is that healthcare professionals can immediately see the difficulties patients could be having with understanding health information.

This review, in my opinion gave a valid study as to why health literacy is a problem among patients that have a comprehension issues. The author gave several results from different literacy screenings showing that if health professional would take some precautions from the beginning and identify patients with health literacy problems would result in better patient care, which in return would give a positive health outcome.