Health literacy and its role in reducing health inequalities

What is health literacy?

Health literacy refers to how well an individual can obtain, comprehend, and use health information and services to make informed decisions about their health. Don Nutbeam’s (2000) classification breaks health literacy down into three categories: functional, interactive and critical health literacy.

Functional health literacy is the basic reading, writing and numeracy skills required to understand information and instructions in health settings.
Interactive health literacy is the advanced communication and social skills that enable an individual to actively participate in healthcare interactions and be involved in decisions about their health and care over time, and in changing circumstances.
Critical health literacy is the ability to critically analyse information and use this to take control of the wider determinants of health.

However, a large proportion of the population do not have sufficient health literacy and, as a result, these people are more likely to have poorer health outcomes.

A study revealed that in England, 42% of working-age adults are unable to understand and make use of everyday health information. This figure rises to 61% when numeracy skills are also required for comprehension. In the US, the situation is even more concerning, with 88% of people possessing basic or below basic health literacy.

How does poor health literacy contribute to health inequalities?

Poor health literacy can result in unhealthy lifestyle behaviours, inadequate management of health conditions, increased healthcare costs and limited participation in healthcare decisions. This is because the information presented to a person isn’t understood, making it inaccessible. What’s more, people with the poorest health are also more at risk of having low health literacy, contributing to health inequalities.

The groups that have been identified as experiencing disproportionately low health literacy include older people, disadvantaged socioeconomic groups, ethnic minorities, migrants, people with long-term health conditions and disabled people.

Improving health literacy is crucial for reducing health inequalities. It can empower individuals to manage their health more effectively, leading to better health outcomes and alleviating the burden on healthcare systems by enabling people to take a more preventative approach to their health.

How does improving health literacy help to reduce health inequalities?

Improving health literacy helps to reduce health inequalities by equipping individuals with the skills, knowledge and confidence, to make informed decisions about their healthcare. People with higher health literacy are more likely to recognise signs of illness and navigate the healthcare system effectively, accessing the right services at the right time. This can help ensure timely interventions, connecting people with the care they need more quickly, which can have a significant impact on health disparities.

Improved health literacy also allows individuals to understand and interpret health information accurately. This includes understanding medical instructions, treatment options, and health promotion messages, which can lead to patients adhering to medication better and making healthier lifestyle choices.

Individuals with higher health literacy can also engage in more effective communication with healthcare providers. This fosters better understanding, promotes shared decision-making and encourages open discussions about health concerns, ultimately leading to more personalised and effective care.

What steps can we take to improving the general public’s health literacy?

According to a report by Public Health England and University College London Institute of Health Equity, the most common strategy to improve health literacy is ensuring that health information is clear and accessible for all, regardless of individual ability. This is a consideration that we’re pleased to see reflected in the UK’s Accessible Information Standard (AIS). The AIS ensures that individuals with additional communication needs have access to health and social care information in a format that meets their specific needs, enabling them to better understand and engage with health information. But what more can we do?

Keep it simple

To ensure that health information is presented in a clear, concise and accessible manner, it’s important that complex medical jargon is avoided and plain language that’s easily understood by people of varying educational backgrounds is used. Reducing the reading age of health information also helps to make health messages more easily understandable. Health materials, including brochures, websites and educational resources, should be designed with readability in mind.

Know your audience

Tailoring health messaging to specific target audiences is essential. Different demographic groups may have varying health information needs and preferences. By considering factors such as age, language, culture and literacy levels, health communications can be more effectively personalised. Employing culturally competent approaches ensures that diverse populations receive information in a way that resonates with their values and beliefs.

Think about format

In line with the AIS, it’s vital that information is provided in formats that cater to specific communication needs, such as large print, braille, audio, pictures, or Easy Read. Incorporating visual aids and illustrations helps to simplify complex medical information and make it more accessible to a diverse audience. These efforts improve the public's ability to access, interpret and act upon health information, empowering them to make informed decisions about their health.

How does CardMedic help to improve health literacy?

CardMedic provides an A-Z library of digital flashcards containing pre-scripted conversations to guide patients with additional communication needs through common clinical interactions. The app improves health literacy by promoting more effective communication between healthcare professionals and patients in the following ways:

Read Aloud: the Read Aloud functionality assists individuals with visual impairments or literacy issues. The audio delivery ensures that patients can access and comprehend medical information more effectively, improving their overall health literacy.
Easy Read: the use of Easy Read improves health literacy by presenting medical information in a straightforward manner for people with cognitive impairments, learning disabilities, and children. It helps patients retain key medical information and feel more confident in their understanding of their health condition and treatment.
Multiple languages: the translation of scripts into multiple languages, including British Sign Language, ensures that healthcare information is accessible to diverse patient populations. Language barriers can be a significant obstacle to health literacy, hindering effective communication and comprehension. By providing medical information in various languages, CardMedic breaks down these barriers and enables patients to understand their health better.

Final thoughts

Low health literacy perpetuates health inequalities, as it hinders an individual’s ability to access, comprehend and effectively use health information and services. Improving health literacy can be a powerful tool in reducing these inequalities and promoting better health outcomes. To achieve this, health literacy improvement strategies must consider both individuals’ abilities and be able to serve people’s needs, regardless of individual ability.

By empowering people with the knowledge and skills to actively participate in their healthcare, we can reduce health disparities and create a more inclusive healthcare system for all. Embracing innovative solutions such as CardMedic that improve health literacy and promote better health outcomes for underserved populations will pave the way for a healthier, more equitable society.

We also wrote a blog about how to make communication more inclusive with one of our charity partners, Alix Lewer, from Include. Why not give that a read next?