Health and Well-Being Matter is the monthly blog of the Director of the Office of Disease Prevention and Health Promotion.
Access to easy-to-understand, relatable, and actionable information encourages individuals to be proactive in seeking to improve and maintain their health. However, too often, information that could benefit people is overly complex, unavailable in languages other than English, or not relevant to an individual’s unique perspective and needs. And even with the right information being presented in just the right way to the right person at the right time, that information may not be able to be acted upon due to various inequities. While striving to be healthy and understanding what it takes to be healthy are not the same thing, the root of healthy living is an adequate baseline of usable knowledge – what we refer to as health literacy. Improving our mindfulness of this, as health professionals and lay persons, is a good start toward more effective communication and perhaps better health and well-being.
Frustrating the basic challenges of increasing health literacy is the recent flood of misinformation being generated in the midst of the COVID-19 pandemic. The damage from such claims is remarkably quick to take hold and sometimes impossible to undo, preventing progress in addressing the crisis, adding to inequity in our health system, leading to mistrust of those messengers who ought to be trusted, and making more urgent the need to recalibrate our stance on health literacy at an academic, political, professional, community, and personal level. Failures in pandemic risk communications (that form of messaging designed to help individuals help themselves through crisis) are the latest and perhaps gravest examples ever of miscommunication. The mixed messages on how one can help themselves in the face of COVID-19 are not so different than the inconsistent and poorly nuanced messages we routinely see regarding how one can help themselves be healthier in general.
The Office of Disease Prevention and Health Promotion strives to address these challenges through efforts to prepare both health professionals and health consumers with the information and resources that they need to better engage with each other and make shared decisions that positively impact the health of individuals and, by extension, the public’s health. My use of the term “health professionals” here is expansive, recognizing that information that benefits an individual’s health literacy is derived from many facets of our lives and not just the traditional “healthcare system.” Our goal is to place health literacy at the forefront of everyone’s health and well-being agenda and make it clear that the path to health equity must include, if not start with, efforts to collectively improve our nation’s health literacy.
That’s why in 2019 we worked with subject matter experts to update the definitions of health literacy to reflect both personal and organizational health literacy. The definitions draw new attention to where information relevant to advancing health comes from, and they make certain that we’re working toward a universally agreed-upon set of principles. Although previous definitions have focused on personal health literacy, the addition of the organizational definition emphasizes that organizations have a responsibility to address health literacy and that it is not solely the responsibility of the person.
Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
Organizational health literacy is 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.
As a physician I learned a long time ago that I have a responsibility to communicate with my patients, as best as I can, at their level of understanding and from their perspective, to ensure that they personally have what they need to consider and make decisions about their own health. This is not always easy, especially when I’m the bearer of bad news or delivering information on complex medical issues. But a patient’s health, well-being, and sometimes even their life depends on my ability to convey health information that the patient can both understand and act on. Everyone who works at any level in our nation’s public health and clinical services systems shares this same responsibility, as do many others who are outside of the systems of health and medical care. In terms of basic civility, I’d argue that we all as a society share this responsibility: that it’s incumbent on each of us and the organizations that we are a part of to apply health literacy principles in practice, to best serve the people who entrust us with their health.
Along with updated definitions, ODPHP has also made health literacy a central focus of Healthy People 2030 with an overarching goal to “Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.” In advancing that goal, we’ve identified three core health literacy objectives that aim to measure how healthcare providers ensure patient understanding and involve patients in shared decision making. An objective also seeks to define reductions in the number of patients who report poor communication with their provider. Healthy People 2030 also has developmental objectives that focus on improvement in provider explanations to adults with limited English proficiency and understanding of medical records, as well as a research objective that targets an increase in health literacy of the population as a whole.
Health.gov provides many additional resources including a guide to help you learn how to design health websites and other digital health information tools for users who may not have strong literacy or health literacy skills. You can also learn about the HHS Health Literacy Workgroup’s National Action Plan to Improve Health Literacy. For specific resources for clinicians to help their patients or clients with their understanding of preventive services, please check out ODPHP’s MyHealthfinder microsite. There, your patients can get personalized recommendations for a variety of health and wellness practices, prevention screenings, and vaccinations. Look for further refinements to MyHealthfinder in the coming year as we continue to help individuals catch up and keep up on preventive health services.
Now is the time to make an honest appraisal of how mindful we are of health literacy and how effective we are in addressing improvements in our nation’s health literacy skills. We live in a unique era where all of us have had our consciousness raised to the implications our health has in our lives. Whether health professionals or simply engaged citizens, we must make good on this opportunity to reevaluate how we talk about health. We must meet each other where we are, appreciate differences in perspective, and learn anew how to communicate so that messages that have the potential to benefit our health are not just heard by all, but also understood and acted upon. To this end, I cannot stress enough the importance of appreciating the diversity of perspectives, beliefs and inherent biases that inform people’s thinking and influence their decision-making. We must make the fullest possible effort to connect more meaningfully in our interactions with others. No matter whether it is you, someone that you care for, or a group of people that you support in another capacity, valuing health literacy as a vital first step toward improving health outcomes is imperative.
Yours in health,
Paul Reed, MD
Rear Admiral, U.S. Public Health Service
Deputy Assistant Secretary for Health
Director, Office of Disease Prevention and Health Promotion