Wednesday, October 28, 2009

Health literacy - what does it mean?


HCCA members and staff have been talking about health literacy in recent weeks. We are thinking about what this means for consumers and the types of supports that could be put in place to improve our health literacy. This is of particular importance at the national level with the current consultations on the National Health and Hospital Reform Commission.

We have pulled together a few definitions that we would like to share and are interested in your feedback.

The Australian Bureau Of Statistics Report on Health Literacy in Australia (2008) is a significant report and we consider it to be critical to health reform in Australia. It defines Health Literacy:

the knowledge and skills required to understand and use information relating to health issues such as drugs and alcohol, disease prevention and treatment, safety and accident prevention, first aid, emergencies, and staying healthy.

A similar definition that we also considered is contained in an online article that talks about the recommendations of Adelaide Thinker in Residence, Professor Ilona Kickbusch, the Healthy Ageing Research Cluster (HARC), to establish the Health Literacy Alliance. Susan Gravier, Co-ordinator of HARC at the University of Adelaide, explains what health literacy is, and how the Health Literacy Alliance aims to help our society.

Health Literacy is not just knowing how to read but knowing how to navigate through life, keeping health in mind and in practice. It's knowing about the body's functions and signs of dysfunction; knowing how to find, interpret and understand information, and how and where to seek further information when required; knowing what constitutes good quality advice, and how to translate this help into action.

Harvard Material on Health Literacy

This Harvard site has a very useful set of guides in plain English as well as lots of information about creating material for adult low literacy groups. The American focus seems to be on the need to cater for people with poor print reading skills. It contains some excellent material for people developing programs and material for the public.


Studies reveal that up to half of patients cannot understand basic healthcare information. Low health literacy reduces the success of treatment and increases the risk of medical error. Various interventions, such as simplified information and illustrations, avoiding jargon, "teach back" methods and encouraging patients questions, have improved health behaviours in persons with low health literacy.

The University of Queensland has released a response to ABS study:

This research has revealed that nine million Australians — or 60 percent of the population between the ages of 15 and 74 years — don't have the basic knowledge and skills to understand and use information about their own health.

The impact of such a high proportion of Australians without basic health literacy skills should be of major concern to anyone wanting to ensure people and communities are better able to promote their own health and prevent disease.

(Professor Robert Bush, Health Communities Research Centre)


acahill said...

I am of the view that clinicians (medical, nursing and allied health) need to do the health consumer course, rather than consumers doing the health literacy course. They should learn to speak in plain English, rather than beat around the bush. Terms that have been used on me include:

"this is a serious illness" which means you are cactus. The disease is terminal and you need to get your affairs in order.

"have you thought about what you are going to do?" meaning you are cactus and what you've got is going to kill you sooner than later.


So, I don't think we should be heaping stuff onto consumers about learning health literacy. Rather, I think clinicians should be learning how to communicate with their patients.

Steph said...

In a sense I agree with acahill, but it is useful to be able to understand that the lexicon is specifically designed to exclude the Consumer. "Health Literacy" (the new expression for "plain English") can only help us. I agree that they "should learn to speak in plain English". But they won't. Clinicians have used this to maintain their position of power and prestige.
Germaine Greer's strength many years ago was that women needed education to learn the language of power to empower women.
Likewise for other marginalised groups. I do not believe that any one is more marginalised than a Health Consumer in the Public Health System.
Clinicians (medical, nursing and allied health) are endeavoring to exclude us as much as possible. The complicated Health Complaints System is a case in point - it could only have been designed to dissuade a complainant from persisting. Without the language, we are more disadvantaged.

And it is one area that needs updating because it is an area that is constantly changing. I do agree that "clinicians should be learning how to communicate with their patients". The arrogance of nursing staff at The Canberra Hospital is a case in point. They have no intention to empower the Consumer. That is why we need updated health literacy.