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About Health Literacy and Plain Language
Health Literacy in the National Limelight
Health literacy is currently
in the national limelight and on the national health agenda. This
results, in part, from key reports issued in 2004 by the Institute
of Medicine and the Agency for Healthcare Research and Quality.
The impact of these complementary reports, that documented the nature
and scope of the problem and the research evidence, was enhanced
by the 2010 release of the National Action Plan to Improve Health Literacy. Many provisions of the Affordable Care Act require and support attention to health literacy and effective communication.
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The Challenge of Health Literacy
While researchers continue to debate
the exact definition of health literacy, most agree that the
term reflects patient/consumer literacy skills as well as the demands of our complex health system. Only 12% of American adults have Proficient health literacy skills–reading,
writing, understanding, computing, communicating and using health information well.
Many factors contribute to health literacy
being a challenge for most American adults, including:
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the need to access and use health-related information
across multiple media, topics, and environments;
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the unfamiliarity of the vocabulary and concepts in health
and medicine;
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the complexity of our healthcare system;
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the increasing demands on consumers to prevent and manage
health conditions.
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Adults are expected to gather and use health information
from media sources as diverse as food and medicine labels to computer
print-outs;
to understand topics ranging from fat grams to medication
instructions; to use high-level reading and analysis skills
in locations ranging
from the grocery store to the hospital. These are not easy
demands to meet.
For the 93 million adults across the country
with limited literacy skills, health literacy is an even larger
challenge.
And many of these adults will be eligible to sign up for health insurance for the first time in 2014. Research
in the past decade has provided evidence that adults with
limited literacy
skills have:
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less knowledge about and poorer adherence to
medication and self-care regimens for certain chronic conditions;
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less knowledge and less likelihood of getting specific
preventive tests and exams, even with equal access to care;
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poorer self-reported health and poorer health outcomes;
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increased hospitalizations and costs.
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Research studies
have also documented that elders (adults 65 and older) and are at particular risk of
low health literacy.
Literacy abilities decline progressively with age, posing
a large and growing healthcare risk as our entire population ages and diversifies.
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Plain
Language: One Response to the Challenge
While research doesn’t provide
any easy “solutions” to
the challenge of health literacy, national reports do
state the need for clear language (IOM report) and “well-conceived
interventions” (AHRQ).
Plain language, as defined by well-established criteria,
IS clear language and certainly is part of a well-conceived intervention.
While not a magic bullet, it can help
all
adults better understand health information and
make wise health-related choices.
Plain Language: What It Is
and Is Not
Some hear the term plain language and think “short
words/short sentences” or “dumbed down ideas” or “low
reading level.” This description is simply
not accurate. In fact, plain language uses evidence-based recommendations
about how to structure, write and design information to facilitate reading ease
and audience understanding. In patient teaching,
it includes ways of verbally
structuring and offering information to help assure
patient understanding.
Plain language is essential in technology-based communication as well. Reading on screen is more difficult and adults tend to skim and scan. We have only seconds to present major points.
Vibrant plain language is far from plain. It’s lively,
engaging, and results in effective communication.
Learning
Plain Language Skills
Writing effective plain language information — brochures, letters, handbooks, self-care instructions, consent
forms, web text,
etc. — requires more than good intentions
and goodwill. It requires skills. The Institute taught those skilll for 22 years.
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