Dr. Genelle Lamont
Appearances
Health Chatter
Health Literacy
Right. That's a good question. So again, I'm kind of looking at things from a systems level approach.
Health Chatter
Health Literacy
So if we were to invest money into having health literacy as a core component of the K through 12 health education curricula, and we made that mandatory for every state, how that would look in terms of prevention is that students would come out of high school, understanding more about how the healthcare system works, how to learn more about their health insurance, where to go for that.
Health Chatter
Health Literacy
When is it appropriate to go to the emergency room versus schedule a regular medical appointment? They would know generally more about anatomy, physiology, and generally how systems work. So when they have pain somewhere, they would know precisely how to describe that pain and the location of the pain so that they can better communicate with their doctor.
Health Chatter
Health Literacy
Right. And I think, again, from folks that are working in public health and some of these advocacy roles to be able to advocate for older adults. And to empower them to ask questions of their healthcare provider that at the end of the visit, at the very least, they should be able to answer the questions of what is my main problem?
Health Chatter
Health Literacy
Why is it important for me to do the instructions that you're asking me to do? And what are some self-healthcare tips that I can bring up, right? That's part of it. Another often overlooked resource are librarians. health librarians in particular can help older adults or anyone in general to access health information sources that are vetted rather than having somebody just do a Google search.
Health Chatter
Health Literacy
And maybe you might come up with some good information, but oftentimes you won't.
Health Chatter
Health Literacy
I have to think of one. So the Minnesota Health Literacy Partnership, I am currently the interim chair for that. The founder and chair, Alicia Odeombo, unfortunately passed away this past year. But she did a whole lot of work. She was part of a quality improvement unit at Blue Cross Blue Shield of Minnesota and
Health Chatter
Health Literacy
So she and a colleague were the ones that actually formed the Minnesota Health Literacy Partnership. And early on, that was part of their work was to work with librarians to provide information more widely to the public. They also developed a toolkit actually specifically for older adults and caregivers on how to better improve their health literacy, where to find resources that are vetted.
Health Chatter
Health Literacy
Correct. I'm sure that this has been an ongoing problem. It was until recently, since the 90s and forward that there were actually studies in place that looked at these different issues and did find that folks that have lower levels of health literacy, you know, had greater use of the emergency room department, more hospitalizations and readmissions, less preventive care such as vaccinations.
Health Chatter
Health Literacy
So certainly part of it, as I had mentioned, is if we can incorporate that health literacy into health education curricula early on during K through 12, But for now, I think the focus should be around making organizations more health literate and also providing that education and training for providers.
Health Chatter
Health Literacy
Now, I can tell you right now, at least in Minnesota, the patient education departments and a lot of the healthcare systems are usually manned by just a handful of employees. And that is their job specifically to develop and write health education materials that are in plain language and are health literate and provide that to patients. But another part of their role is provider training.
Health Chatter
Health Literacy
But because they're such a small group and once you get out and you're past that medical education, you don't have a lot of time to spend on training, even if continuing education credits are provided. So again, another systems level approach would be if we could provide health literacy as a standard part of medical and professional school education.
Health Chatter
Health Literacy
But with that said, if we can do a better job to make opportunities for those that are currently working in the field to get that training, I think the better off we'll be and to encourage them to consistently use those skills that they acquire during their training. So one
Health Chatter
Health Literacy
important piece of that, not only teaching folks how to go back to the basics and use plain language instead of their medical jargon, another powerful tool, but yet a real simple one is called the teach back or the show me method. So that's when you're all done with your visit.
Health Chatter
Health Literacy
And let's say you've shown someone, for example, how to use their inhaler at the end of that visit, you want to say to that patient, Okay, I just want to do a double check and make sure that I've explained things as clearly as I could. Could you show me when you go home how you're going to use that inhaler? And then the patient will then show you exactly how they would use that inhaler.
Health Chatter
Health Literacy
And that way, if they're not doing it right, you can make the correction then. And that way you would be certain that when that patient goes home, they're going to be using their medication correctly or they'll be able to follow your instructions. to it to you?
Health Chatter
Health Literacy
Correct. Yeah, that's a great question. So unfortunately, there's only been real small numbers of studies that have been done in health economics to look at the association between folks having lower health literacy or the system not addressing health literacy for those folks, and then the resulting healthcare costs.
Health Chatter
Health Literacy
One study that gets cited often, Vernon 2007, which has been updated for more recent numbers, suggests as high as $938 billion in waste is spent because of unnecessary hospitalizations. not going in for prevention and all the other issues that we've already discussed.
Health Chatter
Health Literacy
But certainly more money needs to be put into research on health literacy so we can get more precise estimates.
Health Chatter
Health Literacy
Again, it would be great to have some studies to support this. I think there's a lot of studies around miscommunication, purposeful miscommunication around COVID. But again, because health literacy is not routinely taught in K through 12 education, then folks come out with different backgrounds. And again, we did see this during COVID.
Health Chatter
Health Literacy
So we had some folks that maybe had higher levels of health literacy who understood in general how vaccines work, how they're helpful. Um, and so those were the folks that went in and got vaccinated right away. They were the ones that knew how to properly wear masks and did that to protect themselves and their family members.
Health Chatter
Health Literacy
And then you saw the other folks, um, that unfortunately maybe got a lot of their misinformation through Google. It became highly politicized as well. Um, Framed as more of us versus them. We, you know, we're, we're more independent. We don't need to listen to, you know, these ivory tower folks on how to protect us ourselves, or, Hey, this isn't even a hoax.
Health Chatter
Health Literacy
So we had those folks that were refusing to mask didn't go in for vaccinations and a result as a result of that they probably. were more likely to get infected and unfortunately spread COVID to other folks, including those that are vulnerable.
Health Chatter
Health Literacy
And that's why we saw situations where, you know, folks that were working in these critical care units would encounter patients literally on their desk bed, needing to be hooked up to the ventilation saying, I'll take my vaccine now. And they had to say, I'm sorry, but That's not an option at this point.
Health Chatter
Health Literacy
Yeah. I almost wonder too, now that you brought that up, if, if all of us as health professionals, when we were communicating with the public did speak more plainly, right. And it, and clearly that maybe this wouldn't have been as big of an issue. Cause again, um, one interesting story I have is one of my pastimes as screenwriting. And when I was taking some screenwriting classes in St.
Health Chatter
Health Literacy
Paul, um, my sister and I were taking it together and we were writing, um, a science fiction story about scientists. And so our dialogue obviously reflected that. And one of the other students in the class said, wow, you know, you really captured the pomposity of that character. And my sister and me looked at each other and we're like, wow, you know, that's how we're coming across.
Health Chatter
Health Literacy
A scientist like this is just how we normally talk with each other. So we certainly weren't trying to perpetuate portray that we were pompous or anything with that character. But that's what other people are hearing, right? That there's almost this anti-education attitude with some folks or jealousy. And so if you're speaking at that higher level and
Health Chatter
Health Literacy
you know, you don't really show empathy or compassion, then you are kind of coming across right as big pompous elitist. And then that can go. Obviously, that's going to go against you when you are trying to communicate something of a serious nature and you want people to trust you and believe in what you're saying.
Health Chatter
Health Literacy
Let me ask you, there's a couple- There's been studies done, too, that show that everybody appreciates queer communication regardless of their health literacy or the education level. Again, you know, somebody might understand those higher-level words or medical jargon, but that does take some more processing, right? And it's just easier if you just speak plainly for everyone. Mm-hmm.
Health Chatter
Health Literacy
That definitely could. Again, that just goes back to the need of why we need to be incorporating health literacy into medical and professional school education, in addition to just general good communication skills, right?
Health Chatter
Health Literacy
It's tough when you're seeing patients, what, only five to 10 minutes at best at a time. And so it's really kind of hard to build that trust and relationship with that patient. But if you come in already having those skill sets of, you
Health Chatter
Health Literacy
relaying sympathy being open and asking questions of that patient and then using that plain language and following up your visit with the teach back or show back or teach back or show me technique then I think even even if you do have to change providers you know unfortunately that can be a loss for patients again because they already have that pre-existing relationship with that other provider but at least if we're
Health Chatter
Health Literacy
systematically providing this training to medical providers and other professionals, then they can at least have these skills to then to develop their own relationship with that patient.
Health Chatter
Health Literacy
Oh, I was just going to say, yeah, for dental providers, that is a best practice is if you're doing a procedure that you're explaining each and every step, because as you say, it's, quite intimidating. You're laying back in a chair, right? People shoving things in your mouth and right.
Health Chatter
Health Literacy
And it can be, you know, really scary for some folks, but if you are, you know, you have that calm voice and you're explaining each step and giving that patient a break, then that helps to calm those eases and makes the procedure go a lot smoother. Yeah.
Health Chatter
Health Literacy
That's a good question. So I think if there's educational opportunities out there, and again, As I mentioned before, your librarian can be one of your best friends at getting that health information. But just in terms of being able to go to your clinic appointments and navigate that as best you can, one of the good practices that I always tell folks to do is bring a buddy if you can.
Health Chatter
Health Literacy
If you have a trusted friend or family member that can come with you to that visit that can help calm some of your eases, but also if there's things that you don't hear the first time or you forget, then that buddy of yours can help you to get that same information or might have additional questions that you hadn't thought of.
Health Chatter
Health Literacy
If that's not possible, if you can bring a notepad and a pencil or pen to your appointment and just make sure that you are writing things down. And if something isn't clear, you can just, you know, Don't feel ashamed. Just ask your doctor, say, hey, you mentioned this term or this, and I didn't go to medical school. I don't know what this means. Can you explain this in plain language to me?
Health Chatter
Health Literacy
And just make sure that you don't leave that office visit until you have your questions fully answered or make sure that you know what to do when you're out of that medical appointment. Maybe ask for some follow-up.
Health Chatter
Health Literacy
Great question. So if there's providers or healthcare organizations or even public health organizations that are listening on the call. Again, to just recognize that health literacy is very important to patient or consumer health education. Even if you're thinking about things like communicating data or charts, that's still a form of health education, correct? And if you want your end user to
Health Chatter
Health Literacy
your patient, your client, that healthcare consumer, to take your information and be able to actually use it and make sense of it, then you need to be incorporating these health literacy best practices. One way to get that education and get it free is through the Centers for Disease Control and Prevention's health literacy website.
Health Chatter
Health Literacy
You go through something called CDC Train, and there's several modules there for different types of providers, including public health educators. I highly recommend those trainings. They'll teach you the basics about health literacy. They'll explain how you can incorporate that into health education materials, how to make data and reports more understandable.
Health Chatter
Health Literacy
And there's also other great tools on that website too, like the 10 attributes of a health literate organization.
Health Chatter
Health Literacy
A lot of folks have successfully used that as a tool to create an assessment for your organization where you can look through each of those 10 attributes and see where your strengths lie and where there are some places that maybe you need to draw more attention to, such as workforce training, right?
Health Chatter
Health Literacy
really is i'm sensing maybe incorrectly that health literacy is perhaps different for all of us but taken away to know what it what is health literacy well first of all i just wanted to thank you um for inviting me to come to this podcast um we have known each other for several years now and i really appreciate this podcast and the work that you're doing so thank you thank you so to
Health Chatter
Health Literacy
Simply to find health literacy, it's one's ability to find or obtain health information, be able to use and comprehend it, and to be able to then apply that to your own health or for your family or your community's health. But one of the things that people frequently forget too is it's not just your own personal health literacy, but it's also the health literacy of providers and organizations.
Health Chatter
Health Literacy
So on the provider level, it's how well can that individual clearly communicate to their patients so that they understand their health information when they walk out that door.
Health Chatter
Health Literacy
And at an organizational level, it's how that organization incorporates health literacy best practices so that they're training their providers, that their providers are consistently communicating in plain language in a way that people can understand. And it's just fostering that environment of health literacy and patient education.
Health Chatter
Health Literacy
Yeah, so actually health literacy is not a new concept. I think maybe it's something that people are becoming more aware of, but it actually dates back to the late 80s, early 1990s. And it all started with the work of C.C. and Leonard Doak, who actually were health... educators, educators in K through 12 education, as well as part of the US Public Health Corps.
Health Chatter
Health Literacy
So it dates back to our public health roots. And so they had done a bunch of research, which I believe is now archived in the National Libraries of Medicine, where they kind of looked up these different concepts of looking at concepts of literacy. So we have in literacy, we have what are called prose document and quantitative literacy.
Health Chatter
Health Literacy
So basically we probably all understand literacy as our ability to read and comprehend information, but it's much more than that. So prose literacy is basically our ability to read and understand continuous texts. So something that might be in, for example, some type of medical instructions. And then document literacy is particularly around reading and comprehending forms.
Health Chatter
Health Literacy
So if you think of those big, large medical history forms, for example, or even something like a prescription drug label. And then quantitative literacy is just that looking and understanding, reading and understanding numbers. So are you able to calculate a serving size for your favorite breakfast cereal? Or are you able to
Health Chatter
Health Literacy
properly dose yourself with your medication or over-the-counter medication, right? And so literacy, health literacy is part of that literacy, just in the context of the healthcare field, which I just described some examples of that. So it's something that I believe people struggle with all the time, according to the 2003 National Adult Assessment of Literacy, which looked at literacy, but also
Health Chatter
Health Literacy
different domains of health literacy. So looking at, again, literacy, quantitative, which we're calling numeracy, and then looking at digital problem solving skills. And what they found with that study is really only one in 10 Americans have proficient levels of health literacy to be able to properly attend to their own health care, the health care of their family members.
Health Chatter
Health Literacy
And 36% of those in that study really struggle with health information. Part of that could be because of overall reading levels, but there are certainly other factors involved in that as well. And it's not necessarily a situation around your level of education. Certainly those with higher levels of education would be presumed to have higher levels of health literacy.
Health Chatter
Health Literacy
But again, we can't always assume that. Again, going back to the fact that medical jargon and language that we learn stems from those that are within, say, public health fields or medical fields, the fields in which you are learning those terminologies. But everyone else obviously didn't go to those schools. So how would you then expect them to understand the language that you use, right?
Health Chatter
Health Literacy
I think everybody, once we're born and when we go through K through 12 education, we automatically speak plainly. It's only when we go to graduate school and professional school that we kind of forget all that we learned. And we start to be more technical because that's the expectation of these schools, right? Is that you can speak in that way and you can speak with your colleagues.
Health Chatter
Health Literacy
But equally important would be if we also went back to our roots and learned how to speak in plain language and adopting health literacy best practices so that we can apply that when we're speaking with the public, when we're speaking with our patients or clients.
Health Chatter
Health Literacy
Correct. Correct. And actually back in 2010, you might recall that was the passage of the Affordable Care Act and the Plain Writing Act in which government agencies were required to provide documents in plain language and speak in plain language. So there was a movement around 2010 and that's when we had the national plan to address health literacy that was enacted through the U.S.
Health Chatter
Health Literacy
Department of Health and Human Services. So during that time, there's a lot more awareness around the need for health literacy and to implement that into the different professions. But since then, there hasn't been any real major movement towards advancing health literacy in a major way.
Health Chatter
Health Literacy
And I really believe that in that context, we need to be addressing health literacy from a systems-wide approach, tackling education sector, health and human services sectors, etc.,
Health Chatter
Health Literacy
That's a really good question. So there's a handful of tools out there that we could actually use to test someone's health literacy. The problem with those tools is that I guess to use an epidemiology term, cross-sectional, right? You understand what that means? So it's one point in time that we're capturing data.
Health Chatter
Health Literacy
So if you were to take maybe an average over a year, you'd get a better sense of somebody's health literacy. But if you're just capturing it at that one point in time, it's really contextual. It's going to depend on your stress levels for that day, right?
Health Chatter
Health Literacy
in the context of a healthcare visit, it might depend on, have you just received a major diagnosis that say you've have cancer or some kind of inoperable, you know, and so then your, your cognition and your processing goes down when those kinds of incidences happen. So really the best practice in health literacy is to, instead of focusing on the individual and bringing their health literacy up,
Health Chatter
Health Literacy
is to then focus on the provider and making sure that the provider is communicating clearly and speaking in plain language.