Health Literacy has a huge impact on an individual’s relationship with their own health and healthcare experience. The CDC defines health literacy as “ the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.” By this definition, health literacy has clear implications for an individual’s interaction with their health and treatment. There is both personal health literacy as well as organizational health literacy. The difference between the two is that as opposed to personal, organizational health literacy refers to the “degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.” The key point of difference is acknowledging the responsibility of organizations to enable the best possible health literacy for the individual. One’s health literacy is not stagnant and can be improved and diminished based on circumstances and the resources provided to them. Creating the opportunity for the highest literacy should be a priority of any and all health providers.
Health literacy is so important because it directly relates to the level of care attained. Low or limited health literacy skills are specifically linked to poorer health outcomes. Individuals with low literacy may not understand a diagnosis or treatment, the language used to describe necessary care, prescription labels, or consent information. The inability to understand and act on any or all of these pieces of information as a result of health illiteracy can create avoidable health problems.
Health literacy is very interconnected with the informed consent process. Informed consent is the process that happens, most likely after a diagnosis, where a treatment plan is proposed, the treatment/procedure, alternatives, consequences, risk factors, side effects, etc. are all discussed in detail. Then the clinician would get confirmation of understanding and have an individual sign and give consent for said treatment/procedure to take place. In nearly every step of the way, compromised health literacy would put you at a disadvantage. Unless health literacy is top of mind, this lack of understanding can go unnoticed if the clinician is not diligent about ensuring understanding. At Confirmed Consent, we ensure this level of understanding with psychologically developed cognition and competency questions prior to consent so that both patient and provider can be certain they understand what they are consenting to. In addition, the platform we provide the consenting information on allows for review multiple times, at your own leisure, the ability to share with family and friends, and direct message if there is any confusing aspect of the information. Being able to bridge this gap of health literacy in the consenting process, with safety guards in place, is one step of the many that may be made to help elevate the negative effects of low health literacy.
The issue of health literacy, unfortunately, disproportionately affects groups that are already underserved by the medical community. Low health literacy is most prevalent among older adults, minority populations, Those who have low socioeconomic status, and medically underserved people in general. However, an organization that values the impact of health literacy, and can see its effects, will make it a priority to implement systems and interventions that increase understanding and thereby advance patient safety.
The Health Resources and Services Administration has outlined several things that health care professionals can do to help:
- Identify patients with limited literacy levels
- Use simple language, short sentences and define technical terms
- Supplement instruction with appropriate materials (videos, models, pictures, etc.)
- Ask patients to explain your instructions (teach back method) or demonstrate the procedure
- Ask questions that begin with “how” and “what,” rather than closed-ended yes/no questions
- Organize information so that the most important points stand out and repeat this information
- Reflect the age, cultural, ethnic and racial diversity of patients
- For Limited English Proficiency (LEP) patients, provide information in their primary language
- Improve the physical environment by using lots of universal symbols
- Offer assistance with completing forms