HEALTHCARE IN THE UNITED STATES
ACCESS ISSUES IN HEALTH CARE
8.5.6 Health Literacy
The official definition of health literacy from the HHS (2020b) is “the degree to which individuals have the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions” (para. 1). Navigating the healthcare system may be difficult if an individual is not aware of what steps need to be taken and where to go for assistance. Without health literacy skills, individuals do not have the knowledge of where and how to obtain healthcare services or navigate the complex U.S. healthcare system. Reading and comprehending health resources may be a challenge.
The World Health Organization (WHO) (1998) characterizes health literacy as overall encompassing of what is needed for healthcare services to be accessed and utilized by an individual: health literacy implies the achievement of a level of knowledge, personal skills and confidence to take action to improve personal and community health by changing personal lifestyles and living conditions. Thus, health literacy means more than being able to read pamphlets and make appointments. By improving people’s access to health information—and their capacity to use it effectively—health literacy is critical to empowerment.
Health literacy itself depends upon more general levels of literacy. Poor literacy can affect people’s health directly by limiting their personal, social, and cultural development, as well as hindering the development of health literacy (p. 10). In addition, making healthcare decisions and taking responsibility for self-care are also concerns for those who have low health literacy skills (CDC, 2019j).
According to Hickey et al. (2018), characteristics associated with low health literacy are those with lower income levels, limited education, chronic diseases, older age, and non-native English speakers (p. 49). Significantly, however, healthcare providers may not be able to tell from looking at a person which level health literacy they have. Therefore, it is important to assume every patient needs careful instruction and an assessment of understanding because lower health literacy levels can adversely affect healthcare-seeking behaviors, such as understanding of instructions, importance of following directions, and follow-up care.
The Agency for Healthcare Research and Quality (2015) encourages healthcare organizations to develop quality improvement measures to make information simple to comprehend and healthcare systems easy to maneuver. Hickey et al. (2018), recommend incorporating health literacy into the standard clinical care for all patients. Some easy suggestions include the following:
• Use plain language—organize the information, break up complex
information, define technical or medical terms with simple language
• Use visual aids—illustrations, simple drawings, clear labels
• Use technology—patient portals, telemedicine, mobile apps
• Use effective teaching methods—open-ended questions, “teach-back”
communication method, “show back” to demonstrate skills (ACP, 2019)
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