Health Literacy and Plain Language - A growing concept

Health literacy is growing concept in the United States. I believe in over the period of time, the concept of health literacy will be taken by other less developed countries. What is the meaning of health literacy? According to the Institute of Medicine report, Health Literacy: A Prescription to End Confusion, Health Literacy is defined in the as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

In a simple language, Health Literacy means the ability to apply reading, listening, analytical and decision making skills to health situation. For instance, health literacy includes the ability to understand the information given in health insurance forms,  instructions on prescription bottles, on consent form, appointment slips, patient brochures, and doctor’s directions. Remember it is not merely ability to read but it is ab ability to understand.

Importance of Health Literacy

Nearly half of all American adults—90 million people—have difficulty understanding and acting upon health information. Nearly nine out of ten adults may lack the skills needed to manage their health and prevent disease. Fourteen percent of adults (30 million people) have Below Basic health literacy

Health care professionals often use technical language specific to their areas of expertise with the expectation that individuals who are not familiar with the professional jargon will understand the meaning of complex terms. Even people with strong literate skills finding difficult to understand and use the health information. For instance, a doctor may have difficulty in helping the family members with health insurance forms.  

Limited Health Literacy affects people’s ability to –

·         Search any health information

·         Understand and use health information

·         Adopt healthy behavior

·         Act on any public health alerts

The problem of limited health literacy is widespread and multiple studies have demonstrated the seriousness of limited health literacy. 

• Adults with low health literacy are at increased risk of hospitalization, encounter more barriers to receiving necessary health care services, and are less likely to understand medical advice that can affect disease progression. 

• Individuals with limited health literacy skills have poorer health status than the people with enough knowledge of health literacy. The reports concluded that limited health literacy is negatively associated with the use of preventive services (e.g., mammograms, flu shots or regular physical checkups), management of chronic conditions (e.g., diabetes, hypertension, and HIV/AIDS), and self-reported health. 

• Researchers also found an association between limited health literacy and an increase in preventable hospital visits and admissions. 

• Additional studies have linked limited health literacy to misunderstanding instructions about prescription medication, medication errors, poor understanding of nutrition labels, and mortality.

• The few published studies have linked limited health literacy and an increase in medical or healthcare cost. For example, costs associated with medical errors may result from health literacy factors. 

• Limited Health Literacy has psychological costs. Adults with limited health literacy report feeling a sense of shame about their skill levels. They may hide their struggles with reading and vocabulary.

Strategies to improve Health Literacy

Successful demonstrations of evidence based strategies can improve the health literacy. Most of the research studies have shown the positive outcomes by simplifying and improving the written materials and use of plain language to communicate the health issues. Clear communication, in plain language, about health information and services will help create and promote health literacy. Studies have shown that picture-based instructions promote better understanding of how to take medication and decrease medication errors among patients.

Plain language is a strategy for making written and oral information easier to understand and an important tool for improving health literacy. Plain language is communication that users can understand the first time they read or hear it. Plain language is not unsophisticated or dumbing down, however it is clear and effective way of communication. Some key elements of plain language are:

·         - Speak plainly so it’s easy to understand;

·         - Write plainly so it’s easy to read;

·         - Organize information so that  the most important behavioral or action points come first;

·         - Break complex information into understandable chunks;

·         - Use simple language or define technical terms;

·         - Avoid using jargon

·         - Use everyday examples to explain technical or medical terms.

    Let me explain you the concept of plain language with the help of examples:

1) 'The Dietary Guidelines for Americans recommends a half hour or more of moderate physical activity on most days, preferably every day. The activity can include brisk walking, exercise, and dancing'.

In plain language  you explain the same concept in easier way -  'Do at least 30 minutes of exercise, like brisk walking, most days of the week'.

2) 'Give two drops three times a day for earache'.

Although this example seems to be easy to understand, it does not make any sense because it does not clearly mention where to use the drops, either you have to take it orally or locally in to the ears. 

Here plain language will help to make this instruction clear. The instruction should be 'Put three drops in the painful ear thrice a day' 

Benefits of Using Plain Language

1)       Plain language helps to communicate the health information in correct manner. Patients and their family are able to understand the information correctly with fewer misunderstandings or error. Hence patients are always satisfied with the information.

2)       It takes lesser time to explain the information to patients and their family. Hence it saves time of healthcare professionals and patients.

References: 

National Network of Libraries of Medicine. Health Literacy. 2013.