Hidden Problems with Health Communication

COVID-19 has shone a light on the importance of health literacy and clear health communication. Health literacy refers to the public, patients and family caregivers’ ability to easily find, understand and use basic health information and services to make informed health decisions. For the public to have adequate health literacy, providers and public health experts must strive to share clear, accurate and up-to-date information. Yet all too often, health communication is unnecessarily complex and confusing.

Medical science and health care are dynamic and require increasing skills for both providers and the public. Computer literacy is a common expectation of those looking to access health information. Health-care systems often expect patients to have internet access, skills and confidence in using technology.

Numerous studies found that most adults do not clearly understand written online health materials and messaging. Many clinicians fail to grasp the gap between what they intend to communicate and what patients understand. According to the only national survey to date, this national problem is illustrated in the 20% of American adults with low health literacy. The statistics are especially challenging in Louisiana, which has one of the lowest ranks in literacy. In Caddo Parish, 28% of adults have below basic health literacy.

Inadequate health numeracy, or the ability to understand and work with numbers, is a pervasive and often hidden aspect of health literacy. Individuals with low health numeracy may struggle to comprehend graphs, tables, percentages or even medication labels. These skills are essential in accurately understanding and interpreting the data, such as the changing number of COVID-19 cases or vaccination percentages. Math skills are also needed to accurately interpret food labels and dosing instructions on prescription and over-the-counter drug labels. Medication error is the most common medical mistake nationwide.

It can be challenging to find trustworthy, current, evidence-based information when bombarded with health information via TV, newspapers, websites and social media. Information provided by organizations trying to sell a particular product or service is not medical advice.

Physicians, nurses and pharmacists are trusted sources of information, but they may be difficult to reach when seeking answers to a question. Other sources for accurate medical information include community health centers, the National Institutes of Health and support organizations for specific diseases such as heart disease (American Heart Association), Alzheimer’s (Alzheimer’s Association), cancer (American Cancer Society) and many others. Increasingly, health systems are using patient portals to bridge the communication gap. Many patients find these applications convenient, but some – particularly older adults and those with low literacy – may find them confusing or frustrating.

While most health care takes place at home and not in a hospital or clinic, gaining clarity on the steps needed to adequately care for themselves or their loved ones in a home setting is critical.

One simple but important practice to implement when seeing a provider is to ask for clarification on anything one is unsure of. The “Ask Me 3” method is helpful to patients wanting to identify areas of concern.

1) What’s my problem?

2) What do I need to do?

3) What is the benefit of doing this?

It also helps patients or their caregivers to have a list of questions prepared for the provider. Speaking up to clarify any uncertainty about taking or administering medication creates an opportunity to receive more indepth and customized care. Health-care professionals are trained to provide patients with accurate, up-to-date health information in their best interest. After receiving answers to questions, patients should repeat responses back to the provider to ensure that both parties share an understanding of the information and are clearly communicating. Writing down the feedback received is also a good idea.

Health literacy is a two-way street. Patients use their literacy skills to access health information while also implementing that information in their care and their loved one’s health. Providers, health systems and public health agencies should seek to provide services that are easy to access and provide clear, trustworthy and helpful information. Improving health literacy is key to improving health in Louisiana.

As directors of the Health Literary Core for the Louisiana Clinical and Translational Science Center (LA CaTS), we offer practical training, easy-to-use methodology and friendly ongoing consultation to enhance oral and written health communication skills. We also provide consultation in simplifying consent forms and health education materials. Our goal is for Louisiana residents to have access to health information that is easy to understand to help them make informed health decisions.

Terry Davis, Ph.D., professor of medicine, co-chief Section of Health Disparities, LSU Health Shreveport. Connie Arnold M.D., professor of medicine, co-chief Section of Health Disparities, LSU Health Shreveport.