Health literacy in the new normal
Updated: Aug 17, 2020
Health literacy is an essential tool for the successful transformation to a patient-centric healthcare system. Providing access to the correct healthcare information empowers better healthcare decisions and this all starts with ensuring health literacy with patients. As we live through these unprecedented times what impact does health literacy have on the 'new normal'?
Health literacy is recognised to be the degree in which individuals can make appropriate health decisions based on an understanding of health information. A relatively new concept in healthcare, there remains no precise definition. Healthy People describe health literacy as the degree to which individuals can obtain, process, and understand basic health information and services needed to make appropriate health decisions.” whereas, Calgary Charter defines it as the use of a wide range of skills that improve the ability of people to act on information to live healthier lives. These skills include reading, writing, listening, speaking, numeracy and critical analysis, as well as communicating and interaction skills. Consistent in any definition is the importance of engaging each individual to make better healthcare decisions as a result of access to the correct healthcare information.
Around the world, no two cultures are the same. Culture, social and family influences shape our attitudes and beliefs and therefore influence health literacy. Social determinants of health, the conditions people are born, grow, live, work and age also affect the individual's ability to participate in improving their health literacy as these conditions are almost always out of their control. What we watch on tv, what we hear in the news and what we read online through websites, videos and social media channels all heavily impact on the health literacy landscape for any society. Studies suggest there are links between low health literacy and poorer health outcomes, more emergency room visitations, increased hospitalisations as well as higher healthcare costs. In 2006 the cost of low health literacy rates in the United States was between $106 Billion to $238 Billion annually. That same amount would have covered the insurance cost for every single one of the more than 47 million people who lacked health coverage in the United States at that time.
COVID-19: the infodemic
The coronavirus has required communities all across the globe to quickly obtain and apply public health information which has altered our behaviours and changed our everyday lives to help stop the spread of COVID-19. Information such as how to avoid the spread of infection and what to do if you are experiencing symptoms was communicated to the public in an easy-to-understand style just highlighting the urgent need for continuous action on public health literacy. Added to this was the spread of disinformation surrounding the coronavirus pandemic. The World Health Organisation's risk communication team lead the fight against the spread of misinformation - through social media platforms and other outlets - by launching the Information Network for Epidemics (EPI-WIN) which aims to communicate true coronavirus information. As WHO's director-general Tedros Adhanom Ghebreyesus described it, "We're not just fighting an epidemic; we're fighting an infodemic". With the UK Government releasing the simple "Stay at home, Protect the NHS and Save lives" slogan to combat the spread of the virus, we were also subject to inaccurate information, myths about the disease and important information that was not clear or easy to understand, which demonstrated the importance of proper health literacy for the wider public as we were unable to differentiate between fact and fiction which allowed unreliable information to influence our behaviours.
Digital Health Literacy
With over 4.57 Billion active internet users worldwide and more smartphones than doctors per person in Europe, access to online health information has never been easier. For healthcare providers, digital health and patient engagement technologies have become important tools in promoting and empowering their patients to take control of their health and shift to a more patient-centric approach, with 85% of doctors saying that the use of wearables has helped patients to engage with their health. That being said, it is important to remember that there is still somewhat of a digital divide in healthcare as the most substantial users of health and social care in society, including older people and those with long term conditions or disabilities, are least likely to use online tools to educate themselves on their conditions. As Amanda Barrell writes, "a growing move towards projects such as web-based patient support programmes assumes a level of competency that many with long-term conditions simply do not have". Therefore, the use of digital health tools to improve health literacy must be structured in such a way as to align with the changing times but ultimately benefit those who need it most.