Archive | May, 2012

The Problem With Health Literacy

At Creek Content, we spend most of our days deep in the world of health care. We work with clients in highly regulated, complex industries, and for the most part, that means we’re working in health care. A fundamental issue for the health care industry is the idea of “health literacy.”

Health literacy is the idea of not just “literacy” — which we tend to think of as the ability to read and comprehend written material — but also includes computational abilities related to health-care self-management. It means, you can find, evaluate, understand and act upon the information you need to manage your own health successfully. It includes the ability to understand your doctor’s instructions, the ability to navigate the insurance and payment systems, and lots more.

Health literacy is a pretty new term, and it’s been the subject of a number of research efforts in the past 20 years. There’s a lot of information now being created to help health-care providers better communicate with their patients, and all of that is for the good.

However, as we work with clients and content [in the United States], I see a fundamental perspective flaw in the way health literacy is often discussed. Usually the message is, your patients are health illiterate, so you must a. educate them or b. dumb down your info. To an extent, I will agree to the factual truth of the first part of that assumption: the U.S. population is not as literate as we might assume. Angela Colter has done some great work not only researching how people with low levels of literacy search, but also bringing together some critical statistics that everyone in public communications should understand. If you work with the general public, about half your audience has low literacy skills.

And in the health care arena, we see a lot of wailing and gnashing of teeth over these issues — understandably, to a degree. As a society, our health care knowledge has advanced rapidly in the past 100 years. Cutting-edge research is often incredibly specialized, conducted by researchers with years of post-graduate training. It’s not easy to explain that to the rest of us — the majority of the population without multiple advanced degrees in health topics.

Here’s my problem, though. A lot of the discussion in the realm of health literacy has to do with how we educate patients — how do we make them health literate. And that’s exactly wrong-headed to me. Think about this: Do car manufacturers bemoan the fact that fewer Americans than ever repair their own cars, or could even explain how an internal combustion engine works? Do you see phone companies complaining that we don’t understand the realities of managing complex data networks? Nope — they’ve just figured out how to make us as expert as we need to be to successfully use their products.

Health care is different than buying a car, but we shouldn’t need an advanced degree to manage our own health. If that’s the standard, we might as well give up now. Traditionally, the health care industry has viewed itself [with good reason] as an expert whom we should consult for the right answers. What I think the industry is learning is, that that approach isn’t very effective. If ¬†we all want to be healthier, we have to learn how to communicate better — with each other.

Let me be clear — I think Americans should be more literate, health literate and otherwise. But that’s a systemic educational and cultural issue that I don’t think we can ask the health care industry, or patients alone, to solve. Most importantly, we’re doing patients a disservice by suggesting to each other [and sometimes to patients themselves] that they aren’t literate. That’s blaming the victim, to my mind. No one sets out to be less than fully literate.

Instead, I’d prefer to frame the health literacy issue as a health communication issue. How do we create health communications in forms that are easy for our patients [of all education levels] to understand? How do we carefully structure provider-patient interactions in a way that makes it easy for us to communicate clearly and honestly? How do we make the doctor-patient relationship feel like a partnership?

These things are happening in health care, but not nearly enough. When we figure out how to make health care information accessible to all our patients, then we’ll have done a good day’s work.

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