Health Literacy

In 2020, Healthy People updated the health literacy definition. Health literacy now addresses personal health literacy and organizational health literacy. 

• Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
• Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

These definitions are a change from the health literacy definition used in Healthy People 2010 and Healthy People 2020: “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

The new definitions:

• Emphasize people’s ability to use health information rather than just understand it
• Focus on the ability to make “well-informed” decisions rather than “appropriate” ones
• Incorporate a public health perspective
• Acknowledge that organizations have a responsibility to address health literacy

Source: CDC. 

Health Literacy has long been defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information services needed to make appropriate health decisions” (Vernon, 2007). In simpler terms, it involved knowing how to find information, evaluate and use it in regards to health in everyday life. Clear communication between patients and their health care providers plays an important role in health literacy. In addition, it is important to note that “anyone can have low health literacy, including people with good literacy skills” (U.S. Department of Health & Human Services). 

However, health literacy is now being understood as a more complex concept (Kleinman, Baur, Rudd, & Rubin, 2018). Not only does health literacy include the skills of the public, but it also includes the health care system. This involves communication of healthcare professionals as well as the healthcare environment, such as the layout of the organization (Rudd, 2017). Healthcare organizations must work to help reduce literacy related barriers to health information, care, and services. The new definition of health literacy from Healthy People 2030 addresses this through organizational health literacy. 

Health literacy affects people of all age, race and income levels. Regardless of reading level, many consumers favor easy to read materials when they need help understanding their health care. This is why easy to read health care materials are necessary. In addition, people are responsible for making their own health decisions every day. Therefore, it is important that they not just understand the information, but learn how to effectively use the health information (MLA, 2005).

Bibliography

12% of Americans have proficient health literacy.  53% of adults have an intermediate health literacy level. 21% of adults have basic health literacy. 14% have below basic health literacy. (U.S. Department of Health & Human Services, 2008). 

Nearly 30 million people have below basic health literacy (National Center for Education Statistics, 2003).

Nearly 9 out of 10 adults do not have proficient health literacy (U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, 2010). 90 million American adults, or half of American adults, cannot understand or act on the health information they receive (Parker, 2012). 

50% of Hispanics, 40% of Blacks, 33% of Asians are estimated to have low health literacy problems (National Patient Safety Foundation, 2011).

These numbers increase with age, with 66% of US adults 60 years and over having inadequate or marginal literacy skills (Doak, 1996).

Americans read at an average level of 8^th to 9^th grade. 1 out of 5 read at the 5^th grade level. 

However, health care materials are mostly written at a 10^th grade reading level (National Patient Safety Foundation, 2011). This leads to increased poor health literacy due to the fact many Americans might not be able to understand their health care materials.

As previously mentioned, health literacy is also influenced by the healthcare environment. Organizations can make a difference by taking measures to become health literate healthcare organizations. There are numerous documents for this, one of which is the Ten Attributes of Health Literate Health Care Organizations. These 10 attributes can help make it easier for patients to navigate and understand the health care environment (Brach et. al, 2012). 

Bibliography

Information from Institute for Healthcare Advancement's Organizational Systems & Policies Microbadge 

How does limited health literacy affect the healthcare system? 

1. Nonadherence to medical advice. This can include: 
   • Arriving late for health visits or not showing up at all.
   • Not taking prescription medicines accurately or at all.
   • Not following treatment plans.
2. Inappropriate use of healthcare facilities and services
3. Avoidable hospitalizations

   • People with limited health literacy are twice as likely to use the ER for care of preventable illness as those with adequate health literacy. 

4. Trouble enrolling in and using health insurance
5. Economic burden on the healthcare system
   • For example, Vernon et al. states that limited health literacy accounts for 7% to 17% of total healthcare expenses each year. 

   • Rasu et al. (2015) state that an adult with basic or below basic health literacy incurs average costs of $3,362 per year for prescription drugs. Meanwhile, an adult with above basic health literacy has costs of only $910.

   • Researchers found that veterans with marginal or inadequate health literacy cost the system $143 million more than veterans with adequate health literacy.