What you can do to support health literacy

Written by Heather Jacobsen of ClearApple Health Writing

Language matters. Just ask the 6.4 million Americans receiving a subsidy to help pay for their health insurance through federal health exchanges.

In King v. Burwell, the Supreme Court focused on the meaning of 6 words – “an exchange established by the state” – in the Affordable Care Act (ACA). On June 25, 2015 the Court decided that enrollees in federal health exchanges should receive financial assistance from the federal government. Their decision ensures that millions of Americans can afford their health insurance. The ACA is a legal document but it’s a public health document, too.

Unlike the ACA, most health information – whether presented on paper, a screen, or in person – won’t affect the lives of millions of people. But even the most mundane health information can have long-lasting consequences, both positive and negative. At its best, health information informs, inspires, and builds a foundation for healthier decisions and actions. And at its worst, it misleads, confuses, degrades, or even kills.

Make health literacy a priority

Health information can play a vital role in shaping our health-related beliefs and habits. However, to find and use it, we need some familiarity with basic health concepts and certain skills. In other words, we need health literacy – the capacity to find, understand, and use the basic health information and services needed to make everyday health decisions. Your health literacy affects every health-related decision in your life. It includes “minor” decisions such as whether to drink soda or water with lunch (which may have a big impact on your health over time) and major decisions such as which cancer treatment plan to pursue.

In 2003, the National Assessment of Adult Literacy surveyed Americans’ health literacy skills, and found that 88% of English-speaking adults lack proficient health literacy skills. Although 53% had Intermediate skills, over 75 million adults had Basic (22%) or Below Basic (14%) skills.

Number and percentage of adults in each health literacy level, from the National Assessment of Adult Literacy in 2003

Health literacy varies by context and may not depend on education or reading ability. For the overwhelming majority of Americans, a new health concern or diagnosis may come with a steep learning curve.

Clear language that’s accurate, accessible, and actionable won’t provide an instant solution to any of our nation’s biggest health issues, but it’s a start.

Recognize your role in the communication gap

The mismatch between written health materials and readers is well documented. While most health materials are written at a 10th or 11th grade reading level, the average American reads at a 6th to 8th grade reading level. Nine of out 10 adults have difficulty using health information that’s routinely available, so it’s not surprising that people have critical gaps in their knowledge about health issues affecting them.

As a public health professional, you may not be directly involved in clinical care or patient education. But there’s more to understanding and using the health care system than traditional patient education materials. Make a list of the ways that you communicate with clients, the community, students, and even your colleagues:

  • Recruitment flyers, consent forms, letters, and community reports for research projects
  • Website content and social media posts, such as on Facebook and Twitter
  • Administrative forms or instruction sheets
  • Information about your organization and services offered
  • E-newsletters and blogs
  • Webinars or in-person PowerPoint presentations

Each of these represents an opportunity to provide information that’s relevant, engaging, and written in plain language. They allow you to frame the language and discussion in a way that helps, rather than hinders, the way that people understand complex health issues and access health and social services.

Provide information that’s accurate, accessible, and actionable

The National Action Plan to Improve Health Literacy recommends supporting health literacy by developing information that’s accurate, accessible, and actionable. While it’s important to acknowledge the broader components of successful communication – such as channel, source credibility, and dissemination methods –  focusing on language and clear communication is a concrete first step to increasing health literacy. The next time you develop content, whether it’s for an email to a project team or a training video, try to incorporate these tips:


Looking ahead: Challenges to health literacy

Some of the biggest U.S. health issues in 2014 and 2015, according to news and health organizations include (in no particular order):

  • Obamacare
  • Outbreaks of measles, mumps, and whooping cough
  • Infectious diseases that spread worldwide, such as Ebola and SARS virus
  • Medical marijuana
  • Antibiotic resistance
  • Revised nutrition labels
  • E-cigarettes
  • Hospital errors and infections
  • Caregivers for an aging population

These are complex health issues with multiple communication challenges. There’s a quote often attributed to Albert Einstein: “Make everything as simple as possible, but not simple.” Sometimes details and nuances are crucial our understanding of a health issue, along with getting the right information at the right time. Clear language that’s accurate, accessible, and actionable won’t provide an instant solution to any of our nation’s biggest health issues, but it’s a start.