Health Literacy – everyone’s business

1 September 2013

Today’s patients and families have a myriad of health information just a click, a phone call, or an appointment away. The challenge is understanding and processing all that information to meet their health needs. KATHY HOLLOWAY calls on nurses to step up their health literacy skills.

I recently attended the International Council of Nursing’s 25th Quadrennial Congress in Melbourne. The congress brought together almost 4,000 nurses from more than 100 countries and every region in the world to discuss nursing’s key role in improving equity and access to healthcare.

A key message from the ICN congress for me was that health is the foundation for development rather than merely the outcome. One of the significant challenges identified for consumers is the multiple sources of information available to them about health and healthcare from the internet.

A key concept identified in enhancing informed consumer choice is health literacy. Health literacy is defined by the US Department of Health and Human Services as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions”.

How health literate is your organisation?

Health literacy is as relevant for health professionals and healthcare organisations as much as for the populations we serve. An Institute of Medicine (IOM) report last year identified the Ten Attributes of Health Literate Health Care Organisations as:

  1. Has leadership that makes health literacy integral to its mission, structure, and operations.
  2. Integrates health literacy into planning, evaluation measures, patient safety, and quality improvement.
  3. Prepares the workforce to be health literate and monitors progress.
  4. Includes populations served in the design, implementation, and evaluation of health information and services.
  5. Meets the needs of populations with a range of health literacy skills while avoiding stigmatisation.
  6. Uses health literacy strategies in interpersonal communications and confirms understanding at all points of contact.
  7. Provides easy access to health information and services and navigation assistance.
  8. Designs and distributes print, audiovisual, and social media content that is easy to understand and act on.
  9. Addresses health literacy in high-risk situations, including care transitions and communications about medicines.
  10. Communicates clearly what health plans cover and what individuals will have to pay for services.

How confident in health literacy do you feel you are?

A 2010 report suggested that over 50 per cent of

New Zealand adults are likely to experience health literacy difficulties. Poor health literacy affects people’s ability to navigate the healthcare system, provide a clear health history, engage in self-management of health and understand concepts of probability and risk.

The Waipuna Statement 2011: Health Literacy is everyone’s business ( calls upon all health professionals in New Zealand – this means you – to recognise that health literacy is your responsibility. You need to develop your communication skills to meet the varied needs of all your patients and communities; to always check that you have understood the needs and concerns of the patient correctly and always check that your message has been understood by using techniques such as summarising and ‘teach-back’ (also called ‘closing the loop’); and to develop teams with communication and health literacy in mind.

Health literacy has been reported to be one of the strongest demographic factors associated with health outcomes, greater than age, ethnicity and socioeconomic factors. Awareness of the individual and systemic factors that affect the levels of health literacy is therefore important.

One of the key elements identified is the clinician-patient communication from what is being discussed at the point of care, how it is conveyed, whether it’s understood and so on. So it is our job to make sure that we can support health literacy through developing our own skills in accessing and using information appropriately. Nurses are often the initial point of contact for questions and requests to assist in clarifying information found on the internet or given out by other health professionals.

Studies show that people who understand health instructions make fewer mistakes when they take their medicine or prepare for a medical procedure, which means better safer patient outcomes. They may also get well sooner or be able to better self-manage a chronic or complex health condition – so it is our job to be prepared to facilitate health literacy as with awareness comes informed choice.

View or download full document at:

Kathy Holloway is dean of the Health Faculty at Whitireia Community Polytechnic.

Effective Communication Tools for Healthcare Professionals

The Health Resources and Services Administration (HRSA), is an agency of the US Department of Health and Human Services. The role of this agency is to improve access to health care services for people who are uninsured, isolated or medically vulnerable. This free online course is recommended by our own Health Navigator New Zealand site. The stated aims of the course are to assist the health professional to:

  • Acknowledge cultural diversity and deal sensitively with cultural differences that affect the way patients navigate the health care system,
  • address low health literacy and bridge knowledge gaps that can prevent patients from adhering to prevention and treatment protocols, and
  • accommodate low English proficiency and effectively use tools that don’t rely on the written or spoken word

[Site accessed 28 July 2013 and last updated May 2013]

Workbase - New Zealand Health Literacy

This site was developed to support health professionals, managers and policy makers in New Zealand by providing comprehensive free information about health literacy, and easy access to some very interesting resources for both clinicians and educators. There are additionally excellent links on the site to presentations from last year’s Workbase and Health Navigator New Zealand-hosted “From Discussion to Action” conference in Auckland.

[Site accessed 28 July 2013 and last updated July 2013]