The concept of health literacy is actually fairly new. The term was first introduced in 1974, when Simonds argued that students could also be literate in health, just as they are in other subjects, such as maths or reading1. By the 1990s, the World Health Organization (WHO) had taken up the cause, culminating in the publishing of its own definition of health literacy in 1998’s Health Promotion Glossary2. As governments and health systems make pushes towards more patient-centered care that empower patients to share in making decisions about their treatments, the concept of health literacy has never been more important. Read on for an overview, as well as why pharmaceutical and medical device makers should be focusing on health literacy as part of an overall medical communications strategy.
Defining health literacy
Since the WHO brought health literacy to the world stage, the concept has continued to evolve, inspiring a multitude of research on health literacy in a variety of health conditions and contexts. Researchers are now seeking to integrate existing definitions and conceptualisations of health literacy “into an encompassing model outlining the main dimensions of health literacy as well as its determinants and the pathways to health outcomes,” so that health literacy can be better promoted and measured3. In 2012, researchers created a model that “identifies 12 dimensions of health literacy, referring to the competencies related to accessing, understanding, appraising and applying health information in the domains of healthcare, disease prevention and health promotion, respectively” (see Figure 1)3. This is a straightforward, comprehensive lens through which to view the concept of health literacy, so it’s what we’re referring to going forward.
Figure 1. Dimensions of health literacy
The impact of health literacy
As management of chronic illnesses (e.g. diabetes, vascular disease) in particular has come to dominate the global conversation about healthcare, ongoing therapy is often necessary for optimal outcomes. However, health services and clinicians alone cannot be entirely responsible for this burden — patients must also be fully engaged in their care. If they cannot understand what their care regimen is, why a care decision has been made, how to participate in that care, whom to contact about their care, and when to carry out or pursue care options, health outcomes suffer. More specifically, poor health literacy results in:
- Poor quality of care
- Risks to patient safety
- Inability to communicate in public and private dialogues about health, medicine, scientific knowledge and cultural beliefs
- Lower quality of life
- Decreased equity and sustainability in health systems3
Without a system-wide focus on health literacy, people with a variety of acute and chronic conditions may not understand health-related educational materials, making them arduous to self-manage. Without proper self-management, patients have a greater risk of developing many secondary health conditions. This can be a colossal expense for the individual and healthcare systems overall. Health literacy is a core foundation for a patient’s ability to self-manage and should be treated as such.
Approaches to health literacy
Low health literacy levels can broadly be addressed by educating persons to become more resourceful (i.e., increasing their personal health literacy), and by making the task or situation less demanding, (i.e., improving the “readability of the system”)3. That is, patients should have a wide variety of options to choose from, to suit their personal situations and learning styles, and these options must be delivered in a way patients can easily understand. More specific examples ways to improve health literacy for patients include:
Blogs — Written in conversational, easily understandable language, blogs are designed to be quick reads on a single aspect of a bigger topic. This approach allows patients to read about the specific information they’re looking for, and link to other related blogs, if they choose. Patients don’t feel overwhelmed by a paper that tries to do everything at once, which helps enhance information retention. The advantage for pharmaceutical and device-makers is that a regularly updated blog helps SEO optimisation, thus keeping the company at the fore of web search results — and at front of mind for patients and clinicians (who often direct patients towards patient education options).
Websites — A well-organised and well-thought-out website delivers a variety of learning modalities to patients. It’s easy to explain concepts visually (e.g. through infographics, pictures or medical illustrations), provide audio explanations for visually impaired patients, and embed videos that let patients follow step-by-step — or even hear stories from patients just like them. A page with downloadable resources lets patients engage in their education and care even when they’re not online. And a mobile-optimised website means they can check for answers to questions anytime, anywhere on their tablets and phones.
Patient education materials — These can be downloadable or more traditional printed resources. Straightforward language and clear visuals can be integrated to help patients, for example, prepare for surgery with a specific device, self-care after that surgery, how to administer diabetes medication, or how and when to take blood pressure readings.
Apps — Apps have the same anytime-anywhere advantage as websites, but they can take health literacy a step farther by making education interactive. Health literacy is not just about being informed, but about how patients are able to apply that information to their everyday lives and care. Apps can be developed to help guide patients through steps in their care — letting them get ‘hands-on’ experience before actually doing — and to integrate reminders about their care regimens and a place to record their care-related activities, for example.
Engaging patients directly in their own care in one or more of these ways positions companies as more than pharmaceutical and device makers, but as thought leaders concerned about patients’ overall wellbeing.
Health literacy never loses its importance
Too often, patient education materials are written at a readability level too advanced for the average patient. Writing medical information in an easily digestible format is not the same as ‘dumbing it down’. Rather, distilling information for patients requires in-depth knowledge of a therapy area or speciality, so that it can be conveyed in a way that is both technically sound and easy for the average patient to follow. Medicalwriters.com has experts across the healthcare spectrum, experienced in delivering a wide variety of educational materials that can help you lead the way in improving health literacy. Remember: Acute and chronic health conditions can occur in all stages of life, to people of all education levels, and health literacy helps optimise outcomes and save lives.
1. Simonds SK. Health education as social policy. Health Education Monograph. 1998;2:1–25.
2. World Health Organization. Health Promotion Glossary, 1998. Accessed March 2016 at: http://www.who.int/healthpromotion/about/HPR%20Glossary%201998.pdf
3. Kristine Sørensen, Stephan Van den Broucke, James Fullam, et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. Accessed March 2016 at: https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-80