As the effects of COVID-19 continue, we have a front-row seat to observe how health literacy, or sadly in many cases, the lack of health literacy, plays out in our society.
According to the Center for Disease Control (CDC), health literacy is the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services needed to make appropriate health decisions.
With an onslaught of COVID-19 information coming at us from every angle, from both reliable AND unreliable sources, it has never been more important than it is today to make sure we take every effort to bolster the health literacy.
Separating facts about COVID-19 from media hype can be a daunting task. Who are we to believe? For me, I find it useful to examine the data, at the source level, and then use prudent, good judgement about where I will go, what I will do, and with whom I will share my personal space. I tend to err on the side of safety.
For example, just recently I visited my local Walmart store. Even though PPE was recommended, but still considered ‘optional’, I chose to wear a protective face mask and gloves. Before and after my Walmart visit I used lots of hand sanitizer, making sure to not only sanitize my hands and wrists, but also the area of my arms between my wrist and elbow, just in case I had leaned against any contaminated surfaces during my visit. I was among only a few people wearing a protective face mask during my Walmart visit.
I hope the percentage of people using PPE is increasing now that many states are starting to ‘re-open’, or minimally, that more people are following their state’s guidelines for Phase One.
Making Good Health Decisions
Before the COVID-19 pandemic health literacy included choosing and comparing different healthcare plans, understanding prescription drug premiums, evaluating copayments and insurance deductibles.
Having good health literacy requires a certain level of math proficiency, particularly when it comes to performing personal health assessments such as; assessing blood sugar levels, understanding nutrition labels, and calculating cholesterol ratios.
We have always known a certain level of math skills were required to exhibit good health literacy, but it’s really becoming obvious now that we’ve been enlisted in the fight to flatten-the-curve of the spread of novel coronavirus. My guess is many Americans are not sure what ‘the curve’ is, and how their behavior plays a role in flattening the curve.
Even before COVID-19, It’s easy to understand how health information can overwhelm even those with the most advanced literacy skills, especially as healthcare rapidly progresses to include high-tech, wearable technology.
According to an article published in Business Insider titled, “Latest trends in medical monitoring devices and wearable health technology”, by Alicia Phaneuf, use of wearable technology has more than tripled in the last four years. Based on Business Insider Intelligence Research, more than 120 million Americans will be utilizing wearable health technology by 2023.
I would not be surprised to see wearables take on a key role in the fight against novel coronavirus.
How Prevalent is Low Health Literacy?
According to the National Assessment of Adult Literacy, nine out of ten adults may not have the skills needed to manage their health and prevent disease.
These numbers suggest that a large majority of patients may have difficulty understanding medication instructions, filling out complex health forms, managing chronic health conditions, and navigating the healthcare system.
Some factors that affect health literacy skills include; education, language, culture and access to resources. Low health literacy is most likely to include older adults, racial and ethnic minorities, those medically underserved, non-native speakers of English, and persons with a lower level of education.
COVID-19 Shines a Light on the Importance of Health Literacy
“Health literacy is important for everyone because at some point in our lives we all need to be able to find, understand, and use health information and services.
Taking care of our health is part of everyday life, not just when we visit a doctor, clinic, or hospital. Health literacy can help us prevent health problems and protect our health, as well as better manage those problems and unexpected situations that happen.”
What Can be Done to Improve Low Health Literacy?
There are many ways to improve low health literacy and help patients and families better understand health information. The following are just a few suggestions from the US Department of Health and Human Services:
- Identify patients with limited literacy levels and provide information at the appropriate level.
- Use open-ended questions to assess the patient’s understanding. Specifically, questions that begin with “how” or “what” rather than close-ended yes/no questions.
- Evaluate a patient’s understanding before, during, and after the introduction of information and services.
Use the Teach Back method to determine if a patient has understood and encourage them to repeat the information in their own words.
- Use simple language and avoid complicated medical terminology or jargon. For example: Say “fats” instead of “lipids”, Say “harmful” instead of “adverse”, Say “belly” instead of “abdomen”, Say “swallow” instead of “take”.
- Supplement instruction with visuals, pictures, videos and other appropriate materials.
- Consider the age, cultural, ethnic and racial diversity of patients.
- For non-English speaking patients, provide information in their primary language.
- Offer assistance with completing forms.
- Speak slowly and be respectful and clear without being patronizing.
- Summarize what the patient needs to do.
- Explain what each medication is for, dosage, and side effects.
- Make sure the patient knows where the information is written down.
- Consider the following questions when delivering health information:
- Is the information appropriate for the patient’s level of health literacy?
- Is the information easy to use?
Improving health literacy does not always require additional resources. It may include enhancing the effectiveness of the education already being provided and ensuring communication is being delivered clearly and at the appropriate literacy level.
The benefits of health literacy improvement includes better adherence to treatment, increased engagement in self-care, improved health status, greater efficiency, and reduced costs to the health system.
Most importantly, improved health literacy will help us curb the spread of novel coronavirus.
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Jerry L. Stone