Health Literacy Today

For today’s entry I’d like to focus on the issue of health literacy.  “Two decades of research indicate that today's health information is presented in a way that isn't usable by most Americans. Nearly nine out of 10 adults have difficulty using the everyday health information that is routinely available in our health care facilities, retail outlets, media, and communities. Without clear information and an understanding of prevention and self-management of conditions, people are more likely to skip necessary medical tests. They also end up in the emergency room more often, and they have a hard time managing chronic diseases, such as diabetes or high blood pressure,” according to the U.S. Department of Health and Human Services National Action Plan to Improve Health Literacy.

The Herschel S. Horowitz Center for Health Literacy is one of the most distinctive elements of the University of Maryland School of Public Health. The Herschel S. Horowitz Center for Health Literacy was established in Fall 2007 and joins other related organizations and entities such as the Health Literacy Studies Group at the Harvard School of Public Health and Health Literacy Missouri to address the major public health problem of poor health literacy and its effect on health outcomes. The Horowitz Center for Health Literacy is the nation's first academic based health literacy center and is devoted to improving health through the lifespan, with emphasis on closing the health disparities gap. Research is needed to establish the nature of the causal relationships between and among the various factors including culture and society, education systems, health systems and health outcomes and costs and to develop effective interventions and health policy.

Many of us know the phrase health literacy. Its most common definition is the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions, according to Healthy People 2020 and IOM 2004. In terms of operational clarity, I prefer this definition as provided by Hassan and colleagues found here – “Health Literacy” emerges when the expectations, preferences and skills of individuals seeking health information and services meet expectations, preferences and skills of those providing information and services.

The National Action Plan to Improve Health Literacy is of critical importance now, and it is something all public health practitioners should read and have some familiarity with.  This national action plan seeks to engage organizations, professionals, policymakers, communities, individuals and families in a linked, multisector effort to improve health literacy. Cynthia Baur, in a presentation made at an Institute of Medicine Workshop entitled "What's New In Health Literacy Research,” outlined the vision for future efforts in this regard:  Provides everyone access to accurate, actionable health information; Delivers person-centered health information and services; and Supports life-long learning and skills to promote good health.

Dr. Baur went on to summarize the seven goals of the national action plan, including to:

1. Develop and disseminate health and safety information that is accurate, accessible and actionable.
2. Promote changes in the health care system that improve health information, communication, informed decision-making and access to health services.
3. Incorporate accurate, standards-based and developmentally appropriate health and science information and curricula in childcare and education through the university level.
4. Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community.
5. Build partnerships, develop guidance and change policies.
6. Increase basic research and the development, implementation and evaluation of practices and interventions to improve health literacy.
7. Increase the dissemination and use of evidence-based health literacy practices and interventions. 

The Office of Disease Prevention and Health Promotion of the U.S. Department of Health and Human Services developed a site called Health Literacy Online. This guide provides guidance on how to create web sites and content for consumers with limited literacy. This website is an important tool. 

I’ll simply add that for those of you who use Twitter, you will find a very active group of entries related to health literacy there as well. To close I’ll reiterate how important the issue of health literacy is to all public health and healthcare professionals and encourage you to send your comments based on your experience in this area.