What’s That You Say?
By Ann Constantino,
Published in the Humboldt Independent on May 4, 2021
Beginning about 20 years ago a large international group of academic researchers conducted a series of informally linked studies on literacy in industrialized nations.
The questions being asked were mostly concerned with the idea that in a rapidly evolving world in terms of dependence on ever-advancing technology, was the average citizen maintaining the literacy required to “consistently and accurately use and comprehend the printed word and numbers”? This is different from simple functional literacy, or the ability to read and write in their basic forms.
When the results showed that most countries, including the US, scored below the level determined to represent this type of literacy, multiple national and international agencies began asking follow-up questions of how to fix this problem.
At this point, a specific aspect of modern literacy crucial to the well-being of any society, “health literacy”, was conceived by public health administrations worldwide and embraced as a goal within the broader literacy issue.
When a clinician is allowed as little as 11 minutes for an encounter with a patient, how feasible is it to expect them to communicate complex information effectively?
Taken up by the US Department of Health and Human Services’ Center for Disease Control, a variety of approaches has been looked at to remedy the problem. At first, it was assumed that better-educated patients would solve the problem as numerous studies have shown that health outcomes are significantly better for those who have more understanding of the body’s systems, are more able to comprehend treatment protocols, and have the ability to do quality research on their own.
However, this approach highlighted income gaps and offered little in the way of solutions to society-wide disparities resulting in poorer care for economically disadvantaged populations. It brought up the bigger problem of gaps pervading the entire US public education system and was more than a healthcare-oriented method could address.
The CDC next looked at improving the communications skills of clinicians. Obstacles to this idea include the fact that many clinicians are already overwhelmed with keeping up with all the new information, medications, etc, and may not have sufficient comprehension themselves to pass it on to patients. Furthermore, when a clinician is allowed as little as 11 minutes for an encounter with a patient, how feasible is it to expect them to communicate complex information thoroughly and effectively?
Ultimately, the CDC has recognized that the problem must be addressed institutionally, with a system-wide cohesive strategy for improving health literacy among all stakeholders in healthcare. Seen as a public health issue, responsibility needs to be shared by all.
Patients making use of these navigators have seen costs go down and quality of care improve.
A tactic that started out when the Affordable Care Act came online was the use of “healthcare navigators”. Specialists in helping patients determine their pathways mainly through the financial aspects of the new insurance programs, it was noticed that not only did outcomes improve, but costs were cut.
While this type of financial expertise still is in use, another type of navigator has become more and more available and is showing equally positive results. These medical navigators act as a kind of advocate and support patients and their families through a variety of situations, from simple to complex. Available to communicate away from clinic hours or hospital settings, navigators act as guides for understanding medications, long-term management of care, treatment options, risk factors, etc.
Patients making use of these navigators have seen costs go down and quality of care improve. Patients feel they are receiving more personalized care when there is one person helping them through what may be a multi-tiered cohort of providers.
If you are being treated for a major health issue requiring multiple providers and multiple venues for treatment, ask if a healthcare navigator is available to help. If not, ask what other advocacy assistance might be available, and if necessary, bring a friend or family member you are comfortable with to be a second set of ears and eyes as you make your way through your treatment. Southern Humboldt Community Clinic currently has two Patient Navigators on staff to support their clients and are accepting new patients.
Improving health literacy
Another agency under the federal Health and Human Services Department, the Office of Disease Prevention and Health Promotion has developed a National Action Plan to improve health literacy. The plan is based on the two core principles that all patients have a right to the information that enables them to make informed decisions about their care, and that services should be delivered in ways that are easy to understand and that improve health, longevity, and quality of life.
The plan is comprised of seven goals, including incorporating accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through the university level. Other goals are aimed at closing the language and income gaps that tend to leave large groups of people behind resulting in poorer health outcomes for economically disadvantaged groups.
Don’t be afraid to ask questions and insist on getting answers you can understand.
Talk to your primary care provider about ways you can become better informed about general healthcare issues as well as your specific care needs. Be careful on the internet and check with providers you trust for their recommendations for internet or print resources. Don’t be afraid to ask questions and insist on getting answers you can understand. Keep a journal of all your medical encounters and keep a file of all paperwork, handouts, and any informational materials you are given. Read over prescriptions, drug fact sheets, hospital discharge instructions, etc. with a friend or family member who can help you understand and fully integrate the information.
It is often overwhelming to find yourself in a health crisis. Having the ability to fully comprehend all the options, risk factors, costs, possible outcomes, etc. makes a difference in how effective your care will be. Until government agencies are able to successfully complete their plans to improve health literacy, it is up to the patient to be as informed as possible.
Ann Constantino, submitted on behalf of the SoHum Health’s Outreach department.