Promoting health literacy: Bridging the gap between professionals and consumers

December 12, 2023 - By Rachel Kubik, Senior Content Writer for ARC

Fundamental health literacy is important in every interaction between health and wellness professionals and consumers — be it a prescription, treatment or recovery. It may be reading nutritional labels of a product at the grocery store. It may be adhering to a diet plan printed on a newsletter. It may be following nutrition instructions given over a Zoom consultation.

Enhancing health literacy, defined by the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion’s National Action Plan to Improve Health Literacy 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, is important for individual consumers as well as the broader success of the nation.

Clear communication is indispensable for consumers to embrace the recommendations health and wellness professionals provide. Access to accurate, user-friendly health information empowers people to take proactive measures for their well-being. Too frequently, a knowledge gap exists between professionals and consumers.

It’s essential to translate health guidance into practical actions, enabling people to follow recommendations. Two decades of research cited in the ODPHP action plan highlight that contemporary health information is presented in a manner that is largely inaccessible to the majority of Americans. Almost 9 out of 10 adults encounter challenges in comprehending everyday health information readily available in healthcare facilities, retail outlets, media and communities. The absence of clear information and an understanding of preventive measures and self-management of conditions increases the likelihood of skipping necessary medical tests. Moreover, it contributes to a higher frequency of emergency room visits and difficulties in managing chronic diseases, such as diabetes or high blood pressure.

Limited health literacy impacts individuals of all ages, races, incomes and education levels, but its effects are disproportionately felt in lower socioeconomic and minority groups, according to the ODPHP plan. Only 12% of English-speaking adults in the U.S. demonstrate proficient health literacy skills, disproportionately impacting lower socioeconomic and minority groups. This limitation impairs people’s ability to seek and use health information, adopt healthy behaviors and respond effectively to crucial public health alerts. Additionally, limited health literacy is linked to poorer health outcomes and increased healthcare costs.

Additionally, according to the National Institutes of Health, anyone, regardless of education, can struggle with comprehending emotionally charged or complex health information. While health and wellness professionals often aim to convey accurate information, some consumers may hesitate to seek clarification, potentially leading to misunderstandings. The responsibility for ensuring comprehension in healthcare lies not only with consumers, but also with healthcare organizations, their systems and procedures. The increasing difficulty in discerning evidence-based information from misleading content, particularly online, poses a significant challenge. Effectively communicating “risk” remains a complex task for both providers and patients/consumers, and additional challenges arise in navigating insurance plans and benefits, particularly for those unfamiliar with prior coverage.

Each day, consumers encounter situations requiring decisions regarding their health from grocery stores, pharmacies, workplaces, playgrounds, doctors’ offices, clinics, hospitals and the kitchen table. While some decisions occur during face-to-face consultations with health and wellness providers, a multitude are made independently when grappling with often complex and unfamiliar information. Examples include choosing the right health insurance, determining the correct dosage of a supplement or medicine based on instructions from a box or responding to warnings about severe public health outbreaks in their vicinity. People require information that is comprehensible and applicable to make informed decisions and take actions that safeguard and enhance their health.

Health literacy is not only about an individual’s skills, but encompasses the efforts of health systems and professionals to make health information understandable and actionable. The relationship between individual skills and the demands of health and social systems is a crucial aspect of health literacy. Beyond traditional literacy, health literacy requires knowledge about the body, healthy behaviors and the health system. Various factors such as language, communication abilities, cultural background and cognitive and mental health influence a consumer’s health literacy. Achieving a health-literate society necessitates collaborative efforts across sectors to eliminate barriers and enhance communication by healthcare professionals, educators and the media.

The National Action Plan calls for the development of health policies, programs and financing that prioritize the enhanced usability of health information and services. Key areas for improvement include the communication skills of health and wellness professionals, framing and knowledge of complex issues by the media and public health professionals, clarity and accuracy of health information, cultural and linguistic targeting of health information and services, and the enhancement of public health infrastructure, along with community, educational and workplace infrastructures. The plan underscores the importance of simultaneously tackling these items to achieve meaningful progress in health literacy.

The effectiveness of health and safety information dissemination to the public plays a strong role in shaping health literacy. Several characteristics of the health system contribute to challenges in health information comprehension, including the use of technical and medical terminology in public communications, the presentation of confusing or unnecessary statistics, nuanced or unclear recommendations and explanations of risk, an excessive reliance on written communication, a predominant focus on creating awareness and providing information rather than promoting actionable behaviors, and a limited incorporation of cultural preferences and practices when tailoring information and interventions. Addressing these issues is crucial for enhancing health literacy, as these factors can create barriers that impede consumers’ ability to understand, interpret and act upon important health and safety information effectively.

Public health professionals can, according to the plan, enhance health literacy by considering the following strategies: explore the feasibility of a health literacy scorecard or composite index for monitoring on a national or sub-national level, incorporate health literacy measures into data collection efforts, boost support for systems- and community-based research in health literacy improvement, and integrate health literacy factors into the evaluation of public health interventions, extending to areas like chronic disease prevention and management. These measures aim to systematically address health literacy disparities and improve overall public health outcomes.

Health and wellness professionals, encompassing all members of health care or public health services teams, can use various strategies to enhance health literacy:

Diverse communication tools: Utilize a range of communication tools, including vetted pictures, models and scorecards, to support both written and oral communication with consumers/patients and their caregivers, ensuring information is accessible and comprehensible.

Leverage existing programs: Utilize existing programs such as the Agency for Healthcare Research and Quality’s (AHRQ) “Questions Are the Answer” to prepare both consumers/patients and providers for visits, structuring communication effectively.

Child-centric communication: Employ direct and developmentally appropriate communication when dealing with children to enhance their understanding of health and healthcare.

Check patient understanding: Employ proven methods, such as the teach-back method, to check consumer/patient understanding, ensuring comprehension of health information and awareness of risk and benefit tradeoffs related to treatments, procedures, tests and medical devices.

Pharmacist counseling: Ensure pharmacists provide necessary counseling to consumers in language they understand, aligning with legal requirements for dispensed medications.

Patient-centered technologies: Incorporate consumer/patient-centered technologies throughout the healthcare process to support information and decision-making needs, ensuring accessibility and usability for consumers.

Utilize social media: Leverage technology, including social media, to expand consumers’ access to the healthcare team and information, fostering greater connectivity and engagement.

Continuous training: Participate in ongoing training in health literacy, plain language and culturally and linguistically appropriate services (CLAS), encouraging colleagues and staff to undergo similar training.

Advocate for education requirements: Advocate for continuing education requirements for healthcare providers, particularly those who have not participated in health literacy, cultural competency and language access training, promoting continuous improvement.

Patient-friendly environments: Create consumer-friendly environments using architecture, images and language that reflect the community and its values, facilitating effective communication.

Library referrals: Refer consumers/patients to public and medical libraries for additional information and assistance in finding accurate and actionable health information.

Education programs: Refer consumers/patients to adult education and English language programs, recognizing the importance of literacy and language proficiency in overall health literacy improvement.

Promoting health literacy is a multifaceted challenge that requires collaborative efforts across sectors to bridge the existing gap between health and wellness professionals and consumers. By addressing communication barriers, enhancing information accessibility and advocating for education and training, consumers can feel empowered to make informed decisions, ultimately fostering a more health-literate society.