Importance of Health Literacy
Health literacy is the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment. There are multiple definitions of health literacy, in part, because health literacy involves both the context (or setting) in which health literacy demands are made (e.g., health care, media, internet or fitness facility) and the skills that people bring to that situation. Since health literacy is a primary contributing factor to health disparities, it is a continued and increasing concern for health professionals. The 2003 National Assessment of Adult Literacy (NAAL) conducted by the US Department of Education found that 36% of participants scored as either "basic" or "below basic" in terms of their health literacy and concluded that approximately 80 million Americans have limited health literacy. Several factors may influence health literacy. However, the following factors have been shown to strongly increase this risk: age (especially patients 65 years and older), limited English language proficiency or English as a second language, less education, and lower socioeconomic status. Patients with low health literacy understand less about their medical conditions and treatments and overall report worse health status.
In order to have a patient that understands health terms and can make proper health decisions, the language used by health professionals has to be at a level that others who are not in the medical field can understand. Health professionals must know their audience in order to better serve their patients. The language used by these professionals should be plain language. Plain language is a strategy for making written and oral information easier to understand; it is communication that users can understand the first time they read or hear it. The National Institute of Health (NIH) recommends that patient education materials should be not written higher than a 6th-7th grade reading level; further recommendations provided by the NIH Office of Communications and Public Liaison are published in their "Clear Communication" Initiative.
Many factors determine the health literacy level of health education materials or interventions: readability of the text, the patient's current state of health, language barriers of the patient, cultural appropriateness of the materials, format and style, sentence structure, use of illustrations, and numerous other factors. A study of 2,600 patients conducted in 1995 by two US hospitals found that between 26% and 60% of patients could not understand medication directions, a standard informed consent form, or materials about scheduling an appointment. The 2003 National Assessment of Adult Literacy (NAAL) conducted by the US Department of Education found that 36% of participants scored as either "basic" or "below basic" in terms of their health literacy and concluded that approximately 80 million Americans have limited health literacy.
The biomedical approach to health literacy that became dominant (in the U.S.) during the 1980s and 1990s often depicted individuals as lacking health literacy or "suffering" from low health literacy. This approach assumed that recipients are passive in their possession and reception of health literacy and believed that models of literacy and health literacy are politically neutral and universally applicable. This approach is found lacking when placed in the context of broader ecological, critical, and cultural approaches to health. This approach has produced, and continues to reproduce, numerous correlational studies. Level of health literacy is considered adequate when the population has sufficient knowledge, skills, and confidence to guide their own health, and people are able to stay healthy, recover from illness, and/or live with disability or disease.
McMurray states that health literacy is important in a community because it addresses health inequities. It is no coincidence that individuals with lower levels of health literacy live, disproportionally, in communities with lower socio-economic standing. A barrier to achieving adequate health literacy for these individuals is a lack of awareness, or understanding of, information and resources relevant to improving their health. This knowledge gap arises from both patients being unable to understand information presented to them and hospitals' inadequate efforts and materials to address these literacy gaps.
This perspective defines health literacy as the wide range of skills, and competencies that people develop over their lifetimes to seek out, comprehend, evaluate, and use health information and concepts to make informed choices, reduce health risks, and increase quality of life. While various definitions vary in wording, they all fall within this conceptual framework.
Journal of Pharmacy Practice and Education,