According to the U.S. Department of Health and Human Services, nearly 9 out of 10 adults have challenges using information that is routinely available in healthcare facilities, media, and communities.
Isabel Valdez, PA-C, assistant professor in the Department of Medicine at Baylor College of Medicine, discusses why health literacy matters, addressing disparities, and what can be done to improve health literacy in the following Q&A.
Q: What is health literacy?
A: Health literacy can take on different meanings, whether it’s from the patient’s or the clinician’s perspective. Patients should always be informed about their medical conditions and treatments, especially in a manner that will help them arrive at decisions aligned to their goals. From the clinician’s perspective, health literacy consists of meeting patients where they’re at with tools they can use to achieve health and well-being.
Q: Why is health literacy important?
A: There has been a pivot in how we make medical decisions from the hierarchical approach of “doing whatever your doctor tells you” to shared decision-making where we engage with the patient. Research studies are one of the biggest reasons why we have shared decision-making. Following lessons learned from studies conducted in the past, we now inform patients of the risk and benefits of medications and treat patients fairly and compassionately.
We took the oath to do no harm, and that includes being transparent with our patients. The patient needs to understand their disease and treatment options, so that in turn, they can be engaged as we arrive at decisions about their care.
Q: Are demographics a factor in health literacy disparities?
A: Any individual can be affected by low health literacy. If the patient does not understand their medical condition or how we explain their care, we are doing a disservice to them if we don’t bridge the understanding gap. Poor understanding of their health conditions could lead to poor outcomes, such as in the case of worsening heart disease risk from uncontrolled blood sugar or elevated blood pressure.
However, patients who speak limited English may be at greater risk of poor outcomes from not being able to understand care decisions. Personally, I see it in clinic when I treat Vietnamese-speaking patients who immigrated in their youth. These patients are now in their 60-80s and have complex health problems associated with aging that can be difficult to explain without the help of certified interpreter. African American patients have been subject to low health literacy, not because of a language barrier, but because of distrust in the medical system.
In recent history, Black men were in a study where treatment for syphilis was withheld to learn the effects of this disease, which led to unimaginable repercussions to their health. This experience highlights one of many reasons Black patients may distance themselves from medical care and consequently, have a deficit in health literacy.
Q: How does Baylor support health literacy?
A: It starts with the education of our students and trainees. We pass knowledge gained in the lab, classroom and at bedside to the next generation of researchers and clinicians that will impact how they care for patients. Our doctors are not only on the frontlines, but they are visible on media platforms, educating the public on COVID-19, and vaccination. We are reaching the public in several languages and platforms to ensure a wide outreach.
Q: How can we improve health literacy overall?
A: We improve health literacy at a microscopic level by ensuring that every day, our patients understand. The last thing I do with my patients is making sure that I’ve answered all their questions. This is powerful because it’s reminding patients that this is the space where they can always reach out.
Q: How can we improve cultural competency?
A: Baylor supports and improves health literacy at the macro level by educating the next generation of care providers. At the micro level, we as practitioners must be mindful of our patient’s literacy and engage in best practices, such as using a certified interpreter rather than a family member or caregiver, or by providing written information in the patient’s language when available.
Other best practices are encouraging patients to repeat instructions that we give them to ensure proper understanding. We want to prevent miscommunication that can occur from taking shortcuts.
Learn more about primary care at Baylor Medicine.
Read more about Health Literacy Month.
-By Kathleen Franks, senior communications and corporate affairs associate with the Department of Medicine at Baylor College of Medicine