By Anita Jean
Literacy can be described as the ability to read and write. Health literacy is more complex. It includes the ability to read and write, plus the ability to process and understand health information.
Health Quality Ontario explained the potential impact that health literacy has on health outcomes in a presentation for health care providers. Several examples were provided. A person with high health literacy will read information and be able to understand what is needed to keep them healthy. While someone with low health literacy will not be able to do so. Take the example of prescribed medication, high health literacy equals comprehending how to take their prescribed medication correctly, where a patient with low literacy may take the wrong dose at the incorrect time. Another example is Diabetic problem solving and modifying insulin dosing based upon readings, this task could be a challenge for someone with low literacy skills.
The basic health literacy scale has 5 levels
- Level 1: difficult for a parent to figure out the dosage of medication to give a child
- Level 2: the person understands clear simple instructions
- Level 3: comprehension is similar to that of high school and college graduates
- Levels 4 & 5: able to understand complex health information
Health literacy is affected by many factors, such as language, culture, and education. If English is not your first language and the health information is in English, you might not understand the information as well. Try reading the French instructions on a bottle of cold medicine to get an idea of what this is like. Unless you are fluent in French, this will likely be a challenge and could result in improper use.
Health Quality Ontario identifies three skills to promote health literacy: being able to read and write; being able to understand numbers; and being able to ask questions and express yourself. The Manitoba Institute for Patient Safety has a program called "It's Safe to Ask" (www.safetoask.ca). This program encourages individuals to ask their health care providers three basic questions to get the information they need to become active participants in their care. These three questions are:
- What is my health problem?
- What do I need to do?
- Why do I need to do this?
Here are a few more ideas to try. In the Teach Back method, the health care provider asks the patient to repeat the information or instructions back to them, to see if the patient understands. As a patient, you may wish to repeat the instructions back to your health care provider to ensure you have understood the information they have provided you.
- have a family member or friend present to help you understand the information and instructions
- asking for written information in plain language
- relaying the information in a story
- using visuals, audio files or other technology
- increasing your literacy level by accessing a community program
According to the map of health literacy from the Canadian Council on Learning, approximately 33 percent of individuals living in Thunder Bay and the District have the lowest rate of health literacy. An estimated 60 percent of the population of Thunder Bay would have the second lowest level of health literacy and could only understand clear simple instruction and in the region this number increases to nearly 70 percent.
Anita Jean is the Manager of Health and Social Programs at the NorWest Community Health Centres.
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