Dr. Joyvina Evans is an Assistant Professor at Howard University in Washington D.C., a self-care advocate, author, speaker, Founder of Advocating for My Uterus (non-profit), and Creator of Confidence Academy. Dr. Evans earned a Ph.D. in Public Health, an M.S. in Public Health, and an M.S. in Administration. She completed the Women in Education Leadership Program at Harvard University’s Graduate School of Education and Higher Education Teaching and Learning certificate online through Harvard University’s Graduate School of Education. Dr. Evans is a current Health Equity Scholar through California State University-Long Beach Center for Health Equity Research (CHER).
Health literacy is the possession of the knowledge and literacy skills needed to make an informed health-related decision. Health literacy often needs to be clarified with reading levels and literacy levels. While there is a correlation, they are all fundamentally different. There are many definitions, but at the core of health literacy are the common elements regarding the ability to obtain, understand, and use information to make informed decisions regarding health and treatment that will significantly impact health outcomes. Before transitioning into higher education, I worked in clinical research and had direct patient contact. I can attest to speaking with patients with low and limited literacy and ensuring that I took the time to explain the research project and answer all questions. Ensuring that potential participants made an informed decision was a priority.
Low and limited health literacy levels are associated with higher emergency room visits, medication errors, and an increased mortality rate. People with low or limited health literacy struggle with medication adherence, communicating effectively with health providers, and understanding diagnosis and treatment. There have been patients who have overdosed by accident due to taking too much medication or not understanding the instructions. Determining patients’ health literacy level can illuminate their understanding of their health conditions and lead to more appropriate health decisions and outcomes. Different tools are available to determine the population’s health literacy levels (resources below) that health professionals will find helpful, and additional training is available for professors and students.
When working with students enrolled in health-related degree programs, they must be aware of their health literacy levels and have the tools to work with populations with different health literacy levels. Creating a stand-alone health literacy course or, at minimum, incorporating health literacy content into the curriculum ensures that future healthcare employees are well-equipped to communicate with diverse populations and provide them with the necessary information and tools.
The health curriculum should include (at minimum) the following health literacy components:
- A lecture (or module) on the background and meaning of health literacy and ways to identify people with low or limited health literacy. The lecture should also include cultural sensitivity training and discussion on cultural and linguistic norms for communicating with diverse populations. Additionally, the Professor can incorporate and share health literacy resources from reputable organizations such as the Agency for Healthcare Research and Quality (AHRQ) and the Institute of Healthcare Advancement (IHA).
- Content that teaches the importance of oral and written communication delivery. This includes educating on avoiding medical jargon and technical terms or providing information shared in an easy-to-understand and palatable format. This may include charts, graphs, and photos to help the population understand the information.
- Leadership training and skills that prepare future leaders in the fundamentals of building health-literate organizations. Healthcare Leaders must ensure that the organization is health-literate from when patients and families enter the organization through discharge or exit. For instance, this entails ensuring that directional signs are easy to read and understand. I have visited numerous hospitals and had difficulty maneuvering through health systems.
- Assessments where students practice and demonstrate what they learned. Students should be able to practice and demonstrate their knowledge and understanding of the content. This can be done through quizzes or assignments. In a few healthcare classes I teach, I gave a talk on health literacy that included an overview of health literacy, the definition, the importance of health literacy education, and the dangers of low or limited health literacy levels. Within the Health Marketing course, health literacy was tied to ensuring that health materials, commercials, and ads are presented in an easy-to-understand manner. Students were asked to complete a radio ad assignment for a new cancer program. A portion of the rubric and evaluation was tied to examining the community’s health literacy and ensuring that the terminology used within the ad was understandable. The students in the Community Health course were assigned a group project where the group members had to create a community program and a recruitment flyer, both at appropriate health literacy levels based on the demographic and geographic location of the assigned population.
These are a few recommendations to consider and do not include the numerous ways that health literacy can be taught and shared with students. Health literacy content and assessment are necessary to improve health outcomes and help patients understand risk factors, health conditions, diagnosis tests and procedures, and treatment options. Prioritizing creating a new course or including health literacy content and assessment in current classes must be considered. Professors should be able to design health literacy curricula effectively and determine reliable methods to evaluate students’ understanding of their health literacy and how to ensure they can adequately assess patients and consumers. The recommendations aim to increase students’ understanding of health literacy. Individual health literacy levels can increase by increasing the knowledge and awareness of students who will become healthcare professionals. Thus, the healthcare system can better meet the needs of all people served.
- Agency for Healthcare Research and Quality (AHRQ): https://www.ahrq.gov/health-literacy/research/tools/index.html
- Institute for Healthcare Advancement (IHA): https://www.iha4health.org/
- Lopez, C., Kim, B., & Sacks, K (2022). Health literacy in the United States: Enhancing assessments and reducing disparities. Milken Institute. Retrieved from https://milkeninstitute.org/sites/default/files/2022 05/Health_Literacy_United_States_Final_Report.pdf
- Sorensen, K., et al. (2012). Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire. BMC Public Health, 13, 948.
- Wood, H., et al. (2023). Student health and social care professionals’ health literacy knowledge: An exploratory study. Pharmacy, pp. 11, 2.