Christiana Nielsen Policy Brief: Health Literacy Statement of Problem Health literacy is defined as an individuals ability to obtain, retain,

and comprehend basic health information and services needed to make suitable health decisions. Limited health literacy hinders peoples ability to search for and use health resources, implement healthy behaviors and interpret important health messages. According to the US Department of Education National Assessment of Adult Literacy (NAAL) nearly 36% of Americans scored basic, or below basic on a health literacy assessment. Test-takers were asked to perform simple everyday health related tasks such as interpreting medication prescriptions (2003). Individuals who have low health literacy are more likely to not have insurance, less likely to receive preventative care, more likely to be re-hospitalized, more likely to report their health as poor, and to acquire higher healthcare cost. These outcomes weigh heavy on the nation as a whole and add to the health care deficit. Rates of low literacy are disproportionately high among lower-income Americans who are financed through Medicare or Medicaid. Poor health literacy equates to an increase of $50 to $73 billion in misdirected government healthcare expenditures annually (Somers & Mahadevan). In summary, inadequate health literacy rates in the United States adversely impacts the health status of the American people and the economy of the country. Background Health literacy is a recognized dilemma impacting the quality of life of every American. The are many federal resources to aid healthcare professionals to improve health literacy, such as the National Action Plan to Improve Health Literacy, the Plain Writing Act of 2010, and the Affordable Care Act (ACA), better known as Obamacare. These federal programs each require federal agencies and healthcare professionals to use clear and easy to understand language when disseminating information to health care consumers. . The ACA addresses health literacy in Title V, Subtitle A. This section is devoted to amending existing laws and creating new laws related to the health care workforce. Within this section of the ACA there are direct mentions of health literacy. The legislation touches on the issue of research distribution, medication labeling, patient- physician shared decision-making, and workforce development. Each of these suggestions emphasizes the need to improve

healthcare professionals communication with patients and communities in order to improve the access to and quality of health care (Somers & Mahadevan, 2010). The ACA aims to expand healthcare involvement beyond the doctors office. By requiring easy to navigate resources, simply written materials, and clearly expressed verbal cues, more people will be able to successfully utilize the American healthcare system. For example, those who formerly could not read forms or Medicare applications would be able to receive coverage for their families. People will no longer need to over-utilize emergency services, misuse there medications, and can decide to use more cost effective health options. These benefits will drive down the cost of health care for individuals and the American economy. Recommendations Majority of researchers, healthcare industry professionals and government agencies all agree that health literacy needs to be improved and addressed but no entity has created a health literacy program that specifies implementation or regulatory support. The term health literacy is merely mentioned in larger umbrella components. The need to simplify written materials and improving providers communication skills are consistently agreed upon. Little has been suggested to address the consumers, patients, level of education regarding healthcare. Educational programs to improve patients self-managing skills and understanding of basic health information would improve health literacy from the source instead of solely simplifying the dissemination of information. These programs have been suggested but mainly offered to patients suffering from chronic diseases rather than the general public (Bodenheimer & Abramowitz, 2010). Implementation Action needs to be taken to turn popular suggestions into functioning programs. Health care professional communication standards, properly written materials, and educational programs for patients can all be implemented and regulated by both non- governmental organizations (NGO) and government agencies. Government funding to create training programs for physicians to communicate effectively to patients with all health literacy levels allows a standard of clear and concise verbal dialogue to be established. Furthermore, outlined in the ACA, the government will offer scholarship incentives for students to pursue education in urban medication and health literacy (Somers & Mahadevan, 2010).

Next, making sure written materials such as medicine labels, insurance applications, or informational resources are written in simple and easy to understand manner is imperative to ensure the health and safety of constituents of all health literacy levels. Regulatory guidelines must be created and employed to guarantee that health literacy experts approve each piece of written material disseminated to the public. Responsibility would lie with government agencies to create the guidelines, approve the written materials, and enforce the policy. Finally, educational programs to teach patients are a concept that has not been fully address. Most approaches to remediate incompetent health literacy levels focus on diminishing the amount of baseline health education the patient needs to understand information and focus on the putting all communication into laymens terms. This approach does no truly improve health literacy. Instead, programs need to be implemented in public school curriculums to educate the young, seminars can be offered by community centers to inform the public, and presentations should be given in the workplace. Combining NGO and governmental efforts diverse audiences can be reached and educated about healthcare topics. Carrying out stalwart action to implement and enforce current suggestions of economist, scholars, and government officials, would help to ensure health literacy issues are addressed. These suggestions are all consistent with the themes of patient-centeredness and overall quality improvement that are found more broadly throughout current legislation. Conclusion In conclusion, the health care industry often functions as if all patients have advanced health literacy levels and can be can attentive supporters for themselves. When in actuality, there is a large gap that divides the message that healthcare providers mean to convey between what the patient understands. Improved health literacy can address issues of health care access, quality and cost. On state and national level, there is a push to improve the healthcare system through various federal legislations, especially the Affordable Care Act. Poor health literacy hinders peoples ability to reap the benefits that health care reform offer. Without establishing new programs and initiatives to improve health literacy a mis-use of health care services and misappropriated funds will continue to occur. Targeting health literacy can reduce cost and improve the quality of care for all citizens.

Resources Bodenheimer, Tom, and Sharone Abramowitz. Helping Patients Help Themselves: How to Implement Self-Management Support. California Healthcare Foundation. N.p., Dec. 2010. Web. <www.chcf.org>. Department of Health and Human Services. Americas health literacy: why we need accessible health information [Internet]. Washington (DC): HHS; 2008 [cited 2012 Jan 10]. (Issue Brief).

S.A. Somers and R. Mahadevan. Health Literacy Implications of the Affordable Care Act. Center for Health Care Strategies. November 2010 U.S. Congress. H.R. 946: Plain Writing Act of 2010. 111th Congress, 2009 2010. Signed into law October 13, 2010. Available at: http://www.govtrack.us/congress/bill.xpd?bill=h111-946.