Health Literacy 101: An Introduction to the Field

Michael Villaire, MSLM

Michael Villaire, MSLM

Michael Villaire gave an introduction to the field of health literacy. He began by defining health literacy. His favorite definition is the one from the 2008 Calgary Charter: “Health literacy allows the public and personnel working in all health-related contexts to find, understand, evaluate, communicate, and use information.” Villaire prefers this definition because “it puts the onus for health literacy on the provider, as well as the consumer.”

The healthcare system is bewildering to many people, Villaire said. He gave the example of the challenges people face in signing up for health insurance under the Affordable Care Act. Villaire talked about the components of health literacy: reading and writing, listening and verbal communication, numeracy, and self-efficacy. He gave some illustrations of how challenging numeracy is for many of us.

Villaire talked about the relationship between health literacy and culture. He noted that there is often a mismatch between provider demand and patient skill level, as well as between reading level and materials. And he discussed health literacy’s strong relationship with safety, quality, and health disparities. It can be hard to move an organization forward to health literacy. But “there are certain terms that will help you move forward with your goals. Two words: safety, quality,” Villaire said.

Examples were shared of how patients can be harmed when providers fail to give clear instructions. He put the burden on providers to improve their communication. “The fact that someone does not understand the way we choose to communicate is not their problem. It’s a barrier. It’s something we need to address,” Villaire said. “Health literacy is about dealing with the barriers.”

Villaire discussed health literacy myths and listed the barriers to health literacy. He also offered health literacy statistics and noted that people don’t like to admit they don’t read well because they are ashamed, therefore limited literacy is under-reported. He closed the session by explaining why health literacy matters and discussed the impact of low health literacy.

Integrating Health Literacy into Your Organization: Subtle Issues to Consider

From left to right: Jann Keenan, EdS, Janet Ohene-Frempong, MS

From left to right: Jann Keenan, EdS, Janet Ohene-Frempong, MS

Jann Keenan and Janet Ohene-Frempong explained how to integrate health literacy into your organization. They listed issues to consider along the way.

They noted that health literacy reform has worked in pharmaceutical companies, the insurance industry, state health departments, hospitals, and government agencies. They believe that this is “a golden age for organizational change”.

A health literate organization makes it easier for people to navigate, understand, and use information and services so they can take care of their health, the presenters said. They listed the Institute of Medicine’s implied action steps for becoming a health literate organization:

  1. Make health literacy integral to your mission, structure, and operations.
  2. Integrate health literacy into planning, evaluation measures, patient safety, and quality improvement.
  3. Prepare your workforce to be health literate and monitor your progress at doing so.
  4. Include populations served in the design, implementation, and evaluation of health information and services.
  5. Meet the needs of populations that have a range of health literacy skills, while avoiding stigmatization.
  6. Use health literacy strategies in interpersonal communication and confirm understanding at all points of contact.
  7. Provide easy access to health information and services and navigation assistance.
  8. Design and distributes print, audiovisual, and social media content that is easy to understand and act on.
  9. Address health literacy in high-risk situations, including care transitions and communications about medicines.
  10. Communicate clearly what health plans cover and what individuals will have to pay for services.

The presenters discussed some common roadblocks to integrating health literacy into an organization:

  • A lack of compassion and commitment
  • A lack of time and money
  • Legal and regulatory requirements
  • The need to hire, train, and retain staff
  • The need for industry specific guidelines
  • The challenge of including marginal readers
  • The challenges of health system complexity

They offered detailed strategies for how to navigate these roadblocks, based on the IOM’s guidelines.