Written by: Grace Gerbi
Approximately 90 million Americans have limited health literacy, according to the National Assessment of Adult Literacy Survey. Health literacy is defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (US Department of Health and Human Rights). Since 90 million Americans compose almost a third of the population, an alarmingly high number of individuals are not able to fully understand diagnoses, health information, and available resources. In turn, each of these individuals is at a greater risk of facing worse overall health statuses, more emergency room visits, and heightened mortality rates. In a pandemic, these risks are magnified because many people are in a state of confusion and uncertainty. Additionally, health literacy has complex socio-demographic roots that may cause its rates to fluctuate, such as aging in communities or population shifts.
During the pandemic of the novel coronavirus, individuals are entrusted to understand important health information and adapt their behaviors to prevent the spread. Differing and ambiguous COVID-19 online information may give a foothold for coronavirus conspiracies, a misunderstanding of symptoms, as well as a lack of trust between communities and medical providers. The greatest issue at hand is that individuals are inhibited from making appropriate decisions about preventative care and treatment while receiving mixed, often contradictory, information from news media platforms. The World Health Organization has named this overabundance of health information an “infodemic,” escalating quickly after the global outbreak. Among the varying health information about COVID-19, there is a continuous underlying expectation for individuals to be health literate.
A mapping of health literacy rates by the Missouri Foundation of Health identifies that the inner city communities of St. Louis have the lowest literacy rates in the state of Missouri.
The foundation states that, “The maps described [in this report] provide an important step towards advancing action on health literacy in the state of Missouri. However, to be maximally effective, they must be used in concert with an understanding of the demographic distribution of the area and how low health literacy may affect their health and quality of care.” Historic segregation of suburbs and poor urban housing projects in many American cities has exacerbated poor health outcomes in low-income communities, specifically because these areas experience a lack of public service and supportive infrastructure.
According to the Center of Health Care Strategies, many individuals with low health literacy are those with low socioeconomic status, low English proficiency, and publicly-financed health insurance coverage. In St. Louis, a majority of these individuals are minorities that live in areas which have been disproportionately affected by health issues like asthma, obesity, and diabetes. The health issues that many people endure are exacerbated by socioeconomic, racial, and political factors with deep historical underpinnings. On April 1st, 2020, the City of St. Louis released an interactive map of the confirmed coronavirus cases based on patients’ zip code.
The provided data affirms that the highest number of cases exist in low-income communities with limited health literacy rates and lower socioeconomic statuses; COVID-19 is another manifestation of the location-based health inequalities that St. Louis has historically encountered.
Health Literacy Media, a St. Louis-based organization, is inspiring systemic change by engaging with both patients and providers. The organization works to educate patients and caregivers about diagnosis and care, promote comprehensible health information, and train professionals to communicate clearly with patients. In the current pandemic, at-home care poses a large risk of spreading disease to caregivers. Therefore, Health Literacy Media has created a webpage to disseminate health information and communicate national health resources to community members. This page clearly informs individuals of the proper preventative steps to avoid sickness in the current pandemic, as well as how to strengthen one’s health decisions for the future.
“Health literacy might help people to grasp the reasons behind the recommendations and reflect on outcomes of their various possible actions.”Lancet Public Health
In Lancet Public Health’s article detailing the impact of health literacy on the current coronavirus pandemic, Paakkari and Okan affirm that “health literacy might help people to grasp the reasons behind the recommendations and reflect on outcomes of their various possible actions.” Increased social responsibility during the COVID-19 pandemic may spring from an understanding of public health — knowledge which is rooted in health literacy. The development of health literacy is especially crucial in preparing people for situations that require behavioral change and rapid reaction.
While health literacy concerns the individual’s competence to meet the demands of public health, it is also entangled with solidarity and community health. Low health literacy has become an afterthought in conversations regarding national health issues, despite its resonance in vulnerable populations. Rather than underestimating its impact, institutions must further emphasize the close relationship between health literacy and public health. Above all, it is crucial that future development of health literacy includes plain language and accessible information rooted in preparing disadvantaged populations. In order to combat future international health crises, change is required now.
Edited by Amna Hassan