Increasing health literacy increases health equity
A study recounted by the National Institutes of Health tells of a mother who mistakenly pours an oral antibiotic into her 2-year-old’s ear, not understanding the directions for the medication prescribed for an inner-ear infection.
This is an example of a struggle with health literacy. Janet Ohen-frempong, a plainlanguage and cross-cultural communications consultant, explains: “Health literacy is what you need to know and do to be as well as you can be.”
This requires that you need to not only have access to health information but understand and trust it.
The COVID-19 pandemic revealed trust in our health care system is not a given. People do not seek traditional health care for their health information and services, such as COVID vaccines. Instead, they turn to the communitybased organizations they trust, such as churches, community centers or food banks.
The pandemic has also highlighted stark health inequities experienced by racial and ethnic minorities, and other populations. Segments of these populations have higher COVID-19 death rates and lower vaccination rates. Increasing awareness about health inequities is critically important, but it’s not enough. We owe it to Texans to dissolve structures and systems that create or contribute to health inequities. Fortunately, the federal government is taking notice. In 2021, the U.S. Department of Health & Human Services issued $250 million in grant awards as part of a COVID-19 health literacy initiative.
One such award created Health Confianza, a joint initiative of the San Antonio Metropolitan Health District, UT Health San Antonio and the University of Texas at San Antonio to increase the availability, acceptability and use of COVID-19 health information and services in San Antonio’s most disparate ZIP codes.
The field of health literacy is not new. Two decades of research shows 9 out of 10 Americans struggle at one time or another to use the everyday health information in their health care facilities and larger community. This impacts their ability to perform essential tasks, such as following hospital discharge instructions correctly, with potentially devastating consequences.
Certain groups fare worse: racial and ethnic minorities, people with low incomes, those with a high school diploma or less, immigrants and those with limited English proficiency.
Health Confianza is piloting an innovative pledge program to help community-based health organizations evolve into more health literate organizations. These organizations have pledged to make their services more understandable and accessible by participating in a learning collaborative that will equip them to enact policy and practice changes.
A certificate is earned at completion. Clients who see this certificate, similar to a food inspection placard in a restaurant, will know the organization is going the extra mile to earn their trust.
Organizational leaders should advocate and support making systemic health literacy changes. That may mean initiating a quality improvement project, leading the way in policy advocacy or pledging to earn a health literacy certificate. Making these actions the norm for health organizations will nudge the health and wellness systems to be what they are supposed to be.