Health literacy is important for an individual to keep track of his/her health because it majorly impacts the health outcomes. In a community the health prospects of its population depends upon the cognitive awareness about health information. Individuals with low health literacy may not be able to manage their health and are more prone to develop certain chronic diseases. The concept regarding ‘health literacy’ first emerged in the literature in 1974, the idea was to make a rationale about health education and the significance of developing minimum standards for literacy specifically about health in the school set ups.
The 3 distinct levels of health literacy are:
Functional Literacy: The basic skills to read consent forms, labels of medicine, written and oral information by physician, self-care at home and following appointment schedules.
Conceptual Literacy: Range of skills developed by people over a period of time and experiences to understand and evaluate health information to make informed health choices, reduce health risks and better quality of life.
Health Literacy as empowerment: Promotion of health and prevention awareness by involving individuals of the community so that they would understand their rights as patients and their ability to act as informed consumers about health risks of services and products. It is a proactive approach to improve health system through advocacy or membership of community (WHO,2009).
Individuals in rural communities fail to follow physician’s direction for health maintenance due to lack of functional health literacy. Literacy about health is also believed to be a stronger predictor of health outcomes than socioeconomic status, gender, age and education (American Medical Association, 1999). Inadequate health literacy puts the person at a higher risk of getting a disease regardless of the absence of illness. Physicians play a dynamic role in the provision of health literacy to patients because vulnerable populations such as elderly, minorities, uneducated and persons suffering from chronic diseases are at most risk of lack of health literacy and the physician is the only point of contact for them to become aware of health concerns. Political environment and policy processes are also required to establish appropriate resources that impact the quality of life for the population.
Health Literacy is not merely about the ability to read and understand health issues. It requires multiple abilities including reading, listening, analytical and decision making to formulate a concrete understanding about the importance and application of these skills to health circumstances. This skill set may be needed to understand the instructions on prescription, health awareness brochure, appointment slips, consent forms, doctor’s direction and the ability to communicate complex healthcare conditions (National Network of libraries of medicine, June 2013). Disseminating awareness about health issues needs certain skills. Therefore, anyone including doctors, nurses, pharmacists or community health workers who provide information about health and its services also need health literacy skills to understand how to provide useful information , how to communicate about health and health care, guidance on how to seek help about health information and services.
A study conducted in Colorado, Denver assessed association between low health literacy and prevalence of mortality and hospitalization among patients with heart attack. The study concluded that routine assessment of health literacy is significant to categorize a greater number of patients at risk for adverse health outcomes (Pakistan today,2011).
Challenges or perceived challenges related to attaining information may also hinder the process of cognitive awareness about health. Conventionally, people used to consult their physician about any health concerns but after the advent of internet it has become much easier to get hold of information at the ease of smart phones now. Authenticity of information sought on internet is another debate. But people who are less educated and financially weak still face difficulties in accessing health information. They are still relying on the health care professionals for the health information. One to one information sharing with the patient is also a challenge due to trust and relationship building between the doctor and the patient. It’s difficult to gain trust of people with low health literacy. Moreover, if the healthcare provider is different from the patient in terms of age, gender, ethnicity and socioeconomic class then it will be difficult for the patients to communicate comfortably. Some patients pretend that they understand what is said by the doctor and feel ashamed in asking about their concerns due to lack of literacy about health.
Knowledge gaps that have been created due to social disparities can be closed by making health education an important component of the society. Though the process seems painfully slow but it has been identified as the most valuable method of preventing diseases than any other intervention. Lack of health literacy can be a serious social disadvantage for an individual in terms of understanding doctor’s prescription, lab reports, medication dosages, history about one’s health and difficulty in self-care in case of having a chronic disease. Therefore, education about health is important to strategically change the individual behavior about his/her health.
In Pakistan there are only government led health literacy programs on vaccination, family planning, dengue virus and other epidemic diseases. However, there is not a single program focusing solely on health literacy in general. Government?s health policy also seems to be silent about health literacy. NGOs in Pakistan play an important role in providing education about health but still there is a long way to go in order to cope up with the disease prevalence. NGOs define health literacy as information about personal hygiene, diseases of different ages sexes and geographies, epidemics and chronic diseases (Health Literacy- Improving Health, Health Systems, and Health Policy Around, page 172-173). Besides the governmental initiatives on health literacy, there are many pharmaceutical companies and other corporate entities that provide information about health to general public in the form of brochure, advertisements and campaigns. Another strong media for the general public to get hold of health information is radio. A mass population listens to radio daily and it plays a significant role in promoting health literacy. Many radio channels have a dedicated time for programs on health literacy in which not only they provide information about health concerns but also suggest treatment options for less educated population.
To see the change coming in health behaviours of the society, reputable pharmaceutical companies and health care organizations should take the lead. Opportunities should be provided side by side with the healthcare professionals to the general public as well. Awareness sessions should be held in hospitals, educational and vocational training institutions in epidemic areas. Television plays an important role in cascading information to mass populations through campaigns and celebrity endorsements. Already so much has been done on breast cancer awareness through our media; if same could be done for the other health issues then it would leave a remarkable impact on the health outcomes of less educated population specifically. Literacy programs can be done both by mass media as public service messages, and as workshops for health workers, especially lady health workers and DOTS facilitators. As a result they will become responsible contributors in creating awareness on widespread health concerns in their communities.
Health literacy has a known impact on an individual’s health outcome…..that’s why they say that ?Prevention is better than cure?. Policy makers should inculcate a health care system in which health literacy should be considered as a powerful tool for the patient?s empowerment. It’s about equipping a common man with the basic knowledge about health and prevention of disease so that any adverse health outcome can be delayed or restricted.