Improving health literacy for healthier workforces

two young women having a conversation about health care

Health literacy is not a new idea. It’s been a national topic among health care providers, insurers, and government agencies for decades. That’s because health literacy has a direct impact on health outcomes. But what is it exactly? 

Health literacy is the ability to read, write, and understand health-related communications. This includes material ranging from prescription dosing instructions to post-surgery recovery procedures and everything in between.

Health literacy and social determinants of health

Since 1980, the Department of Health and Human Services (HHS) has engaged in a “Healthy People” initiative to improve national health and well-being. The current initiative, “Healthy People 2030,” has an increased focus on social determinants of health (SDOH). 

Healthy People 2030 defines SDOH as “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” 

Improving health literacy requires taking all of these things into consideration and communicating with individuals in culturally sensitive ways through trusted channels at an appropriate education level. Most American adults at average health risk read at an eighth- or ninth-grade level. But some populations may read below a fifth-grade level. (Source: The Literacy Problem

“There are persistent gaps in health literacy. We have identified effective and evidence-based opportunities to improve this,” says Dr. Oralia Dominic, medical policy research analyst at Highmark. “These opportunities align with and are informed by Healthy People 2030 and the Health Communication and Health Information Technology (HC-HIT) Workgroup within the HHS Office of Disease Prevention and Health Promotion.” 

“Alignment with these initiatives provides health literacy data that helps track progress over time,” Dr. Dominic continues. “It is essential to understand and meet the patient where they are, and consider their attitude, knowledge, and beliefs. We also need to pay attention to body language and respect cultural norms.” 

“Is the patient smiling because they comprehend what they heard or are they just being polite? Do they trust someone else to help them make health care decisions?” she questions. “Grandmothers, mothers, and fathers hold places of authority in many families. We need to be aware of that.”

Guiding principles for health literacy

The Centers for Disease Control and Prevention (CDC) has created a health literacy website to support effective health care communication across diverse audiences. 

The site includes comprehensive information about researching, developing, testing, and evaluating communication materials against established health literacy measures. There’s also an option to sign up for weekly health literacy updates. 

“The core principle is that we have to look at patient care through a health equity lens,” says Dr. Dominic. “Providers, insurers, and employers must assess health literacy disparities to help people achieve the best health care outcomes.” 

“That means using the patient’s first language and preferred cultural terms when describing health conditions, diagnostic tests, and health plan benefits,” she explains. “It means communicating plainly and employing visuals, like infographics, to share information.” 

At Highmark, we’ve always been ahead of the curve in our communications. We are a mission-driven organization that leads by example. Our commitment to the community powers a comprehensive strategy that includes not only our members and employees, but also representatives from culturally diverse communities and in-network care providers. 

“We utilize community-based frameworks to build strong outreach models that address SDOH, including health literacy gaps,” explains Dr. Dominic. “My peers and I create health literacy policies and develop understandable, inclusive, and respectful materials.” 

For example, we published our COVID-19 toolkit in 27 languages. The toolkit included accessible risk reduction communications and infographics rooted in science and aligned with regulatory information.

Health literacy in the workplace

Providing employees with health care coverage is just the beginning of creating a healthier workforce. Ensuring that all employees understand their available benefits takes additional thought and effort. 

Dr. Dominic encourages companies to take an enterprise approach to health literacy by engaging their Diversity, Equity, and Inclusion (DEI) team. The team’s training and knowledge can help close gaps of understanding, while also addressing SDOH among the employee population. 

“Of course, there needs to be a strategic plan and buy-in from leadership for these efforts to be sustainable,” she stresses. “At Highmark, we have institutionalized DEI across our enterprise. We established the Enterprise Health Equity Institute (EEHI-DEI) and a Social Determinants of Health (SDOH) department. We measure health disparities so we can continue to close gaps and provide actionable resources for our provider network, customers, members, and the general public.”

Seven steps for successful health care visits

Dr. Dominic shares these steps to help patients at all levels of health literacy get the most from their provider visits and insurance coverage:

  1. Write down your questions before your appointment.
  2. Ask those questions and write down the answers in a notebook or on your phone.
  3. Try to be open about your physical condition or concerns. Don’t feel scared or embarrassed. The more your provider knows, the better they can treat you.
  4. Ask your provider about all available treatment options and work together to choose the right one.
  5. Schedule recommended follow-up visits and be sure to contact your provider with any new symptoms.
  6. Stay up to date on preventive care. Highmark publishes preventive care schedules based on age, gender, and preexisting conditions.
  7. Call your health insurance plan for support. Some plans offer wellness resources and access to health coaching.

All references to “Highmark” in this communication are references to Highmark Inc., an independent licensee of the Blue Cross Blue Shield Association, and/or to one or more of its affiliated Blue companies.

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