Health Communication, Health Literacy, and the Affordable Care Act

November 8, 2012

If you are like me, you imagine a time when you will be less ‘scheduled’. This has been a time of being over-scheduled in the past half dozen weeks. I have a pile of topics I want to discuss relating to communicating about health. And too little time to do so.

One of the topics that keeps coming through my piles relates to an article written by Stephen A. Sommers and Roopa Mahadevan that was commissioned by The Institute of Medicine–IOM–and published in October 2010. I came across it when preparing to talk about health literacy and health communication with my undergraduates last year. It has been shuffling about on my desk since then. Today is finally the day I will share my thoughts about it.

First, the relationship between health literacy and health communication that I discuss with my undergraduates in a ‘designing health messages’ course is two-fold. On the one hand, low levels of health literacy, meaning the audience is unlikely to understand many health and science terms or be able to use math and statistics to make decisions–suggests that health communicators, whether they are public health program planners or medical doctors, should adapt their communication so that it will be understood, and informed decisions can be made based on an accurate understanding. A great deal of health communication message design research and practices focuses on this effort, working to assure that knowledge gaps do not become wider between more and less educated audiences, for example.

The second issue related to health communication and health literacy relates to efforts to improve health literacy. In other words, how could we communicate to motivate someone with low levels of health literacy to become excited about learning more vocabulary and applying more statistics in making choices about health?  

Addressing both health literacy issues in health communication is the ethical thing to do. Knowing that someone does not understand health vocabularies or may be embarrased to ask questions when they do not understand places a responsibility on the health communicator to adapt. Knowing that high levels of health illiteracy uniformly exist in the U.S. suggests that health communicators ought to be involved with improving the situation across the many contexts for talking about health.

Stephen A. Sommers and Roopa Mahadevan open their paper with the statement that the Affordable Health Care Act does not address low health literacy directly. BUT–they assert–the law cannot be successful unless national efforts strive to address low health literacy. Health literacy is mentioned in the ACA in relation to research dissemination, shared decision-making, medication labelings, and workforce development. “All four suggest the need to communicate effectively with consumers, patients, and communities in order to improve the access to and quality of health care” (p. 6).

So there we have it. If we are to achieve the aims associated with the ACA, including improving the population’s health and bringing health care costs under control, we will only achieve these aims through communication that adapts to and accommodates low levels of health literacy while motivating citizens to improve their health literacy.

 

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