Nationally, it is estimated that 9 out of 10 adults have difficulty understanding health information.  Even individuals with advanced education (if they are not employed in field of health care) when faced with a new diagnosis and anxiety sets in, can feel overwhelmed and confused. When someone gets news that their chest x-ray is “positive”, what does that mean? Does it mean that they have “good lungs”? Do they think they can keep smoking?

Over the past three decades health literacy has emerged as a prominent field of research due to the many challenges and complexities of health care. Health care, like most professions, has a language of its own, and the differences between its vocabulary and that of everyday conversation can make it difficult for patients to understand their diagnosis and follow instructions.

Alabama, along with many other states have taken measures to improve health literacy using a grass roots approach through advocacy and research opportunities.  The Centers of Disease Control and Prevention has a section dedicated to health literacy and the Alabama Health Literacy Initiative is recognized as one of the 25 states that have an official health literacy organization dedicating resources to educating the public so they will have a better understanding of how to navigate the healthcare system.

Health literacy has been one of the goals of the Alabama Health Action Coalition (AL-HAC) since 2017. Housed in the UAB School of Nursing and supported with a research grant from the Alabama Public Health Department, Joy Deupree, PhD, RN, FAAN and co-lead of the AL-HAC is the lead investigator on the grant to study health literacy in Alabama.

There are many factors that contribute to the challenges of health literacy, “the vocabulary of health care may be the primary issue, but there are other considerations that can get between you and a clear understanding of the meaning you are trying to communicate,” Deupree said. “English is a second language for more patients these days, and important nuances can be lost in the translation. Likewise, declining vision, hearing and cognition may cause communication difficulties with the escalating aging population. Poor reading skills, dyslexia, other learning disabilities, limited education, and low cognitive function can interfere with understanding and make following instructions for medication difficult.”

To raise awareness of health literacy, Healthy People 2030 linked health literacy to health equity. One of the initiative’s overarching goals demonstrates this focus: “Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.”

Nurses are responsible for most discharge teaching and patient education, and they spend more time with patients and families than most other healthcare professionals.  Time constraints limit nurses from always having the amount of time to properly educate a patient or their caregivers prior to discharge or during an office visit and once they return home, the challenges then become more challenging.

The advocacy and research nurses and other healthcare professionals are conducting to study health literacy in an effort to improve patient understanding are an important part of efforts to improve our healthcare system. For more information on how you can get involved in advocacy efforts for health literacy in your state and include it as part of you Action Coalition’s goals, contact Dr. Joy Deupree at deupreej@uab.edu.