Health Literacy — it’s not you, it’s all of us.

Guest post written by Xu Cheng, First Literacy Board Member and Head of Business Intelligence & Insights at Ascot Group

dr-rima-rudd-health-literacy-its-not-you-its-all-of-us-first-literacy-blogHave you ever felt foreign when talking to doctors? Hypertension? It means high blood pressure. Pulmonary? It means in the lung. Malignant? It means bad. Ischaemic? Is that medical jargon or the name of a hospital wing?

If you find that healthcare information and medical terms are hard to understand, you are not alone. According to the National Assessment of Adult Literacy, only 12% of Americans have proficient health literacy skills.

Dr. Rima Rudd is a founder and leader in the field of health literacy studies and faculty member at Harvard T.H. Chan School of Public Health. Her research focuses on health disparities and literacy related barriers to health information, health programs, and health care. Dr. Rudd drafted the first national call to action, served on the Health Literacy Committee at the National Academies of Science, and developed the first population-based measure of health literacy.

Dr. Rudd was the keynote speaker last year at First Literacy’s Spotlight on Innovation in Adult Basic Education. Her research and insights are eye opening. While there is much work to be done, the good news is that understanding complicated medical jargon is not all on you – it is a shared responsibility.

What is health literacy?

According to the Centers for Disease Control and Prevention (CDC), personal health literacy is the degree to which an individual has the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

But this is only HALF the picture. Health literacy is not all on the individual’s shoulders.

The CDC also defines organizational health literacy as the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

The takeaway, according to Dr. Rudd, is organizations have the responsibility to address health literacy and help people. So, what is being done to help adults overcome health literacy related barriers? Dr. Rudd shares her insights.

Q: Was there any “AHA” moment in your journey to improve health literacy?

A: Yes! The AHA moment came when we realized maybe it is not the patient and maybe I (as a health provider) don’t have good communication skills. Maybe it is not that they don’t understand, but perhaps we are not providing what they need. Literacy is not a characteristic of a patient, a family member, or any individual. It is an exchange between patients and support and medical professionals. You can’t judge the skills of the listener without understanding the communication skills of the speaker. You can’t judge the skills of the reader unless you can be sure that the writer is doing a good job, was coherent, was clear.

Q: What work has been done since that AHA moment?

A: Focused improvements were introduced in four areas: texts, skills, tasks, and contexts; and the intersection of these areas is health literacy. We not only need to improve the skills of individuals (patients and the public), but we also need to improve the skills of medical professionals. We must ask doctors, “Do your patients understand you?”. In an effort to improve the skills of individuals, some colleagues and I developed Health Literacy Study Circles, a series of facilitated exercises for adult educators. The study circles give adult educators an opportunity to think about how to integrate health-related topics into their normal daily work, to improve students’ literacy skills and thereby increase their ability to access needed health information, to obtain coverage and care, to interact with health workers, and to advocate for their rights. We also led more than 100 hospital tours with adult learners and adult educators, to learn from them. We wanted to understand what helps individuals find their way and what gets in the way. We then used this information to develop The Health Literacy Environment of Hospitals and Health Centers to assess the literacy demands of hospitals.

Q: What does good look like in health literacy?

A: Paulo Freire, a Brazilian educator, philosopher, and leading advocate of critical pedagogy, insists on dignity and respectful dialogue. His work has been a big influence on my health literacy endeavor. Health literacy is a shared responsibility and shared burden between patients and doctors, between public and medical professionals. You must be clear, and I must listen. I must explain, and you must listen. We also need to find a way to establish a dialogue that is respectful, where we are both speaking the same language, where we are listening and talking to each other in an atmosphere that is supportive. We need to make it easier for people to have access to entry, to navigate the medical world (physically and literally), and to dignity. Once you feel you can navigate the system, you feel that it is designed to help you, you’ll feel dignified and comfortable, to absorb and understand the knowledge, and to make well-informed health-related decisions.

Q: How can adult educators help?

A: Adult educators need to help democratize the knowledge, to help people gain access to insights, to help make the knowledge easier to understand, to keep raising the voices on what works and what doesn’t. Adult educators are essential to improving health literacy skills and their work is very much appreciated!

At First Literacy, we play a part in this shared responsibility. We understand that teachers and adult basic education organizations have an important role in improving health literacy. Our free professional development workshops are an opportunity for educators to learn from experts and our grants enable Adult Basic Education organizations to pilot innovative literacy programs.

Join us in our quest to eliminate literacy-related barriers to healthcare by donating to First Literacy.

Note: Dr. Rudd’s responses were taken from her keynote speech during the Spotlight on Innovation in Adult Basic Education in November 2021.




April 21, 2022

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