Blog Global Health Center

Health literacy: The most important social determinant of health?

Written by Carla Edgley BSc (Hons), MBBCh BAO candidate, University College Dublin, Ireland and 2021 Institute for Public Health Summer Research Program participant

As an international student from Australia studying abroad in Ireland, the opportunity to learn from world leaders in the public health field at the Institute for Public Health Summer Research Program, Public & Global Health Track is invaluable to me. During the program, I have felt privileged to hear from captivating speakers about many different public health challenges.

It is a well-known trait of Australian people to shorten or abbreviate as many words as we can. I have been surprised at how many words and phrases other English speaking people have never heard! I have also been fascinated by the different means of communication and etiquette which occur between predominantly English-speaking countries, which I am often learning myself as an international student in Ireland.

Carla Edgley: As a Clinical Trials Coordinator in Australia, during the informed consent process, I often communicated with patients who spoke little to no English and unfortunately, were not always eligible to participate in our research due to their health literacy levels.

We communicate with others in many different ways every day, more so than we often realize. Our body language, mannerisms, facial expressions, and actions alongside the language we speak are constantly used to communicate with others. In the health care setting, communication can be a matter of life or death. When we are sick, a hospital feels like a safe place for many, as we are in the hands of professionals who have been trained to care for us. For others, who cannot understand these professionals, I imagine it could feel terrifying.

As students in the Summer Research Program, we were very fortunate to listen to a presentation by Cindy Brantmeier, PhD, professor and director of Applied Linguistics about the research she conducts internationally and domestically examining language use in health services when managing linguistically diverse patients. Professor Brantmeier discussed how language is directly related to health literacy via the different ways in which we communicate. When we consider the potential challenges a non-English speaking patient can face in a predominantly English speaking healthcare system, there are a multitude of barriers, particularly the ability to advocate for themselves and their care.

According to the National Academy of Medicine, health literacy is the “degree to which individuals can obtain, process and understand the basic health information and services they need to make appropriate health decisions”Many may not realize that health literacy is dependent upon the “skills, preferences and expectations of health information and care providers”, a key focus of Professor Brantmeier’s research. Poor communication attempts have been highlighted during the COVID-19 pandemic, as governments have relied on health literacy for a positive public response to the pandemic. Improving health literacy in patients who are linguistically diverse requires appropriate training for the healthcare workers who are providing care to these patients.

The aspect of Professor Brantmeier’s presentation that resonated with me the most was that health literacy is the most under-studied of the social determinants of health, yet it is the strongest predictor of health. According to the Center for Disease Control and Prevention, patients with low health literacy are more likely to visit an emergency room, have more hospital stays, are less likely to follow treatment plans and have higher mortality rates. This is a clear indicator that further research into health literacy will be impactful and necessary.