Friday, 11 December 2015

Health Literacy

Lots of work is being done around the concepts of Health Literacy.

What is Health Literacy? There are various definitions. This is the one currently from the Australian Commission for Safety and Quality in Health Care 

"Health literacy is about how people understand information about health and health care, and how they apply that information to their lives, use it to make decisions and act on it.

Health literacy is important because it shapes peoples health and the safety and quality of health care. Low levels of individual health literacy contribute to poorer health outcomes, increased risk of an adverse event and higher healthcare costs"
From 2012,  the Australian Commission for Safety and Quality in Health Care have been conducting consultations and reviews about Heath Literacy. Eventually a Health Literacy National Statement was developed.

In all this information, it is acknowledged that 60% of adult Australians have non functional health literacy skills. This is higher than the generally quoted 44% of people with non functional literacy, as Health literacy does require additional skills, including understanding of numbers and quantities, pros and cons of information, and also a higher number of less familiar words in the content. ABS#4228, 2013

It is also acknowledged that people who are at higher risk of poor health and poor health outcomes, also have poor educational attainment or are from poor socio-economic areas. They are more likely to have chronic conditions such as chronic diabetes, obesity. It has been shown time and again people with non functional literacy present to their health practitioners at a later stage of their health issue, have less awareness of warning signs or symptoms, have poorer uptake of intervention or following the intervention accurately, and not surprisingly when you read this, have poorer health outcomes.

Of interest is that Health Literacy research parameters list a wide range of domains to consider to improve health literacy. A 2015 paper is one like many which talks about measurement against 9 different domains to determine Health literacy. These being
1) Feeling understood and supported by healthcare providers;
2) Having sufficient information to manage my health;
3) Actively managing my health;
4) Social support for health;
5) Appraisal of health information;
6) Ability to actively engage with healthcare providers
7) Navigating the healthcare system;
8) Ability to find good health information;
9) Understand health information enough to know what to do.

You can see that domain 9 on this list is about providing health information “enough to know what to do.” An interesting statement. To date, this is usually seen as writing medical information, by removing most of the most technical of terms from the documents, and using Plain Language techniques. However, this is only going to improve the understanding for a small number of people, who already have good literacy, but maybe have little medical knowledge.  

What about the 44% of the adult Australian population (Similar % in Canada and UK, higher in US) who cannot read to this level?

Health information must be written in an Easy English style as well. Otherwise the many people who do not have functional literacy, will still not be able to meaningfully access information about their health. Who are these people?
The person in the street and/or the person who may want to engage with their health practitioner or about their health
· People with poor educational outcomes
· Early school leavers
· Hearing impaired or people from the Deaf community
· People with Mental Illness
· People with intellectual disability and/or learning difficulties
· People with Dyslexia and other reading challenges
· People with diagnosed lifelong disabilities, eg:, Cerebral Palsy.
· People with acquired disabilities eg: after a stroke , after a car accident, dementia.

In addition, other people who value Easy English are those who are
· highly stressed
· time poor 
· with sick family members
· sick themselves.
Also people who have English as a second language can and do value the availability of Easy English. Think of a new migrant learning English, someone who has come from a refugee camp, or someone who has not read much in English, even though they have been here for many years.
Where is this health information in Easy English?

There are a few places starting to develop their resources in this vast area. But all health messages need to include Easy English in their suite of accessible documents. How can you educate the community if as many as 60% of people can not functionally read your health messages?

These links will take you to some work being done in the UK. Some is clear and easier to read than others, but you can see it is quite different to the traditional information provided to patients and people looking for information about their health.

Here is an example of Easy English developed by Access Easy English in partnership with the Country Fire Authority Vic. It shows you how information can be developed in everyday words so people can read, understand and use the information meaningfully.

Call me to talk about how Easy English can be included in your suite of health and education materials for your patients and the wider community.

Cathy Basterfield
Access Easy English
Consultant – Speech Pathologist
Telephone: 0466 579 855

Facebook: (recent projects)
Twitter: @accesseasyengli 

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