Low health literacy rates are prevalent throughout the developed world . For example, in the USA low literacy levels are at an astounding 88%, and in Canada levels are as high as 80%. Whilst in UK and Australia it is around 60% whereas in the Netherlands low literacy levels are only 30%.
Low health literacy levels present huge challenges for patients such as:
· Lacking the ability to assess general health information
· Poor understanding standard medical terminology/language
· Deficient management of their own health in the context of their own daily lives, social interactions and work environment
· Not following through with the advice given to them by their doctors and other health care
· Inadequate understanding of health funding and available support networks
· Poor compliance of prescribed medication and health promotion advice
All these aspects not only result in frustration for the doctor but also lead to increased hospitalization, emergency care and increased demands on the under-pressure healthcare system.
I work in the Vocational Education sector in Australia where I manage training programs for adult health care workers. As a growing number of healthcare clients are from Culturally and Linguistic Diverse (C.A.L.D.) background, we continually face challenges of low health literacy levels which is prominent among Seniors. So we have a training framework in place which abates this issue. These strategies can be modified to suit the primary healthcare environment and help alleviate the problem in dealing with low literacy levels.
So what can be done to improve the situation?
· A different level of communication is needed for patients with low literacy. Doctors and
other health professional should attempt to use language that is familiar to the patient.
· Supplement the spoken information during the consultation with leaflets, but check for
understanding , as sometimes the patient with low literacy level may have difficulties with
reading or understanding written information.
· Any clinic letters should be followed up with a phone call to the patient to check for
understanding of the written instructions
· Health care professionals are also advised to speak slowly and avoid jargon. For example,
perhaps instead of using the term ‘chronic’ they may use other more familiar terminology
to the patient such as “repeated” or “long-lasting”
· Consider using a whiteboard for drawing a diagrammatic representation to supplement
the verbal information conveyed to the patient/client
· ‘Trigger words’ are a standard pedagogical technique employed in adult education for
people with low literacy levels. Trigger words are action words used in conjunction with a
related word; these are a catalyst for learning or following through with an action. These
are motivating actions for the patient to follow through. For example , ‘Go to the optician”,
“Eat less salt”, ‘Drink more water” etc.
· Consider referring clients to bilingual clinicians/services who speak the client’s language
· Take a positive approach to care and promoting the strengths of the patient’s strengths.
· Ensure there are no distractions (e.g. avoid unnecessary noise, heat or glare in the
· Ensure that client privacy is upheld
· Use a qualified interpreter, when affordable
These may seem as simplistic advice, but the challenge is implementing these strategies when one is faced with the pressures of time and budget restriction. However, in the long run this application may save resources. The focus in modern-day health care is “ Person centred care” and this involves a collaborative and respectful partnership with the patient.
If we can overcome low health literacy level we can empower our clients and allow them to make decisions which will affect their life and sharing power and responsibility over these decisions whilst providing accessible and flexible services which respond to the changing needs of clients. here to edit.