Health literacy is still going strong as a field, and continues to be at the center of many policies and practices. Here’s four sometimes-overlooked reasons to feel good about health literacy.
Listen here and read the transcript below.
TRANSCRIPT
Health literacy is not going away! In this episode, I’ll talk about several reasons to be happy about the patient safety and quality issue that everyone is still talking about.
Hi everybody, I’m Dr. Anne Marie Liebel and this is “10 Minutes to Better Patient Communication” from Health Communication Partners. Our expertise is in teaching people and organization how to get better at communication. Our new course teaches all patient-facing employees to manage common obstacles to equity in patient communication. Why? Because every interaction with a patient is important. And everyone who interacts with patients deserves high-quality communication support. So from Cafeteria to Cardiology, we’ve got you covered, with Foundations of Equitable Interpersonal Communication in Health. Learn more at healthcommunicationpartners.com.
Now with health literacy, there’s huge interest still, after more than 20 years. There’s loads of action and momentum. That’s big, and important not to take for granted.
There are so many resources and people and communities making more resources every day. We got the new CDC definition back in 2020. I’ve been lucky to participate in and observe health literacy activities, health professionals helping contribute to better health and wellbeing for everyone. Whether it’s connecting people to services or information, or helping people get the most out of their healthcare, or continuing reflective practice as professionals, and asking hard questions of ourselves.
So I want to encourage everybody and say, “Yeah! This is good!” Let’s keep unearthing our assumptions, including those about health literacy. Assumptions about what health literacy is.
No one’s denying that health literacy involves skills. And most people I think it’s safe to say are on board with health literacy being context-specific. What’s also interesting is that recognition of health literacy as a social practice, and that it’s tied in complex ways to culture, are also gaining ground. And if you’ve heard this show before, you know this is how I see health literacy. I’ve been banging this drum for years on this show! All of my episodes about health literacy are from this perspective.
So I was super excited when last month the WHO released a report that said, “Importantly, health literacy is understood as a social practice whereby decisions about health, and the available support to change, or maintain, healthy behaviours, are determined by powerful and unique community norms and cultures, and organizational and political factors impacting communities.” I’ll put a link to that report in the notes.
So yes, I want to encourage everybody to keep unearthing our assumptions about health literacy. How? Well, here’s some food for thought, four reasons, maybe some less-talked about aspects of health literacy, that I think you can feel good about that I shared a while back.
Based on my background and experience in health literacy, and literacy more generally, here are 4 things to keep in mind so you can feel more confident–or perhaps see yourself as more competent–when it comes to doing something about health literacy.
- You know more about health literacy than you might think
We all use language every day. Think of language as something in our human tool kit.
There is nothing magical about health literacy in and of itself. Health communication is a special subset of everyday communication. What trips us up in everyday communication can also trip us up when it comes to health literacy. But many of the same strategies and approaches that work well for you in everyday language can be helpful in health literacy.
For instance, let’s say you’re sending a text message. You know that you increase the chances of your message being understood when you take your audience into account. You make some choices in terms of what you include in that message and how you phrase it, based on what you know about the receiver.
This is good news when it comes to health literacy.
Even small changes can bring your message in line with what matters to your patients and their families. They’re your audience. And rather than worrying about a patient’s low score on a literacy assessment, focus on the ways they are successful users of oral, written, and multimodal language.
- Health literacy happens nearly everywhere, every day, with everyone
Let me explain. No, it’s too much. Let me sum up.
As I mentioned earlier, There are many different definitions of health literacy. Most of them agree in the main. Most of them focus on an individual’s skills, or capacities. And the differences in these definitions tend to be fine-grained. however, there are a few definitions over the years that have looked to expand the skills and capacities focus. They do this primarily by seeing health and literacy as “sets of interrelated cultural practices” or activities that we all engage with. For that I’m pulling from the 1997 article that kind of kicked this off.
This more social view of health literacy seeks to complement the skills view of health literacy, since we’re all doing skills in certain social situations. This is helpful because it situates health literacy in everyday life. Sure, the clinical environment gets most of the research attention. But that’s not the only place health literacy happens. Since most of people’s lives are lived outside of the clinical environment, far more health literacy goes on outside the health setting than inside.
Examples of health literacy in action are all around us. For example, here’s some health literacy situations I have been involved in, over the years:
- An ER pediatrician deciding how to articulate bad news to parents so they can make care decisions
- An adult child searching online for alternative therapies for his dad’s prostate cancer
- A medical educator socializing her students into the academic language of medicine
- A woman jogging on a treadmill in a gym watching TV ads for pharmaceuticals
- A patient advocate negotiating a bill on behalf of a clinic patient
Health literacy happens all over the place. More frequently than it might seem. And it involves all of us.
- Health literacy is an interaction
When we talk, listen, read, watch, or write something, we are interacting with other people and with our environment.
When we read, for instance, we are always reading something, for some reason, written by someone(s), and we are somewhere when reading it. We consider these contextual factors, sometimes unconsciously, as we read and make sense of what we’re reading.
Health literacy is no different. Every day, people encounter and interpret information related to their health and healthcare.
Consider those examples I just mentioned of health literacy in action. Each of these are complex interactions between people, messages, and settings.
We don’t communicate in a vacuum. Where we are, when, why, who we’re with, what we have—all of this makes a difference to the way we use language use. You know how It makes a difference how you talk, when you consider who you’re with and where you’re at. That’s easy to see. So it’s a short leap to imagine how it also makes a difference to how we listen, read, and understand.
You knew this already. I’m reminding you of it, so it’s not far from your mind the next time you think about health literacy.
- Health literacy is not…
Health literacy is not a proxy for education. Or intelligence. Or social class. Or motivation. Or overall health. Or compliance (sorry, adherence).
You know, for instance, that being highly educated does not mean having all the information one needs to deal with a health situation. Or knowing the difference between similar-sounding medical terms. Or being savvy with insurance. Or easily navigating a health system. And yet all of this is part of health literacy.
Even people who are labelled as illiterate (by one measure or another) have multiple sophisticated ways of reading a text or image, keeping track of items, measuring and weighing, estimating and calculating. Your patient may have scored badly on an assessment, but that doesn’t mean they don’t do any reading or writing in their everyday lives. Remember this when you face your patient, and you’ll both benefit.
You’re working hard at communication and you know health literacy is important. That’s why you’re here. You want something that helps because you give a darn about your patients. And you know that communication is central to your ability to do your job well.
So these reminders are to help you focus on the parts of health literacy you can actually do something about: the conversations you have with patients, and any written or digital communication. In short, any way words and images are used before, during and after the patient encounter.
Because all this is health literacy, and health literacy involves all of us. This has been “10 Minutes to Better Patient Communication” from Health Communication Partners. Audio engineering and music by Joe Liebel.
