This article was originally published in our Spring 2022 print issue.

In the wake of the COVID-19 pandemic, an important public health issue has been brought to our attention: health literacy. While the world is facing a viral pandemic, it is also facing an “infodemic” of misunderstanding, miscommunication and misinformation. The Centers for Disease Control and Prevention have outlined two distinct types of health literacy: personal and organizational. Personal health literacy is the ability to find and utilize health information at the individual level. In contrast, organizational health literacy is the degree to which organizations empower individuals to find and utilize health information. Health information can come from many sources such as healthcare providers, digital media, word of mouth and scientific journal articles. 

The true importance of health literacy is that it has the ability to impact the health of both individuals and populations, and this is especially true in societies that value individualism and free choice such as the U.S. However, if individuals are tasked with the ability to make important health-related decisions that have the ability to affect their own health as well as the health of their community, they need the skills and tools to do so. Health literacy impacts decision making, which in turn may affect prognosis. This may include treatment adherence, self care and cost of healthcare. 

The importance of health literacy has become especially apparent during the era of COVID-19, when the actions of individuals, such as social isolation, mask wearing and vaccination have the potential to impact the course of the pandemic. This prompts us as a society to assess the role and limitations of health literacy. With complex and rapid crises, it may not always be possible to emphasize critical health literacy, in which readers contextualize information and compare it to their values. In these instances, public health experts may find more success in conveying the fact that some issues are too complex and unpredictable for everyone to individually assess and reach conclusions about. For example, attempting to explain the mechanisms of the available vaccines for COVID-19 is more confusing than emphasizing that the vaccines have been carefully studied and deemed them safe. This second course of action would better persuade the public to quickly adapt to the recommendations of health experts.

Another issue in the era of COVID-19 is disinformation, or incorrect information. Sometimes people misinterpret their experiences. Someone may say that they became sick after receiving a COVID-19 vaccine, and this may dissuade others from receiving the vaccination as they presume the vaccine causes illness. However, most misinformation is spread for reasons related to someone’s image. Dr. Linda Neuhauser, a professor and member of Health Research for Action at UC Berkeley, explains that there are two main reasons that people spread misinformation: to keep their identity, or for political reasons. People may not even believe in the misinformation they spread, they merely do so for ulterior motives. An example of this is congress officials not wanting to promote vaccination due to their political status, even though they themselves have been vaccinated. Regardless of the reasoning for spreading misinformation, the result is the same: negatively affecting individuals’ ability to correctly interpret health information and make decisions.

Although there is some critique of individual critical health literacy, there is much room for improvement that could significantly impact the decision-making of the U.S. population and could address the current infodemic. In the U.S. population, according to the National Assessment of Adult Literacy (NAAL) survey, only 12% have proficient levels of health literacy. Low health literacy can act as a barrier to care, can make individuals less likely to promptly access health care services, and has the ability to impact health outcomes and mortality negatively source. 

Certain populations are more affected by low health literacy than others. One study found that low income is associated with lower health literacy in older urban adults. Thus, addressing health literacy is an issue of equity as it is social determinants that affect it. Dr. Neuhauser explains that immigrants and those with lower English reading skills are more affected by issues in health literacy, and that improving health literacy is a key part of addressing health inequities. It can be easy to put the blame on the public, but healthcare professionals actually have more responsibility to be educated in the subject and make health information accessible.

A way that healthcare and public health professionals can work to address the health literacy crisis is to improve organizational health literacy. Researchers can make an effort to publish content about their studies at a lower reading level to make it accessible to the general public. Dr. Neuhauser emphasizes that health professionals should focus on what people need to do in order to prevent overloading people with information. Dr. Neuhauser further mentions that a key to risk communication is showing that you care. There is a saying in the field of risk communication that “they want to know that you care before they care what you know.” This allows people to be more open to listening to what healthcare professionals have to say. 

As the world faces the COVID-19 pandemic, we also face another epidemic related to health literacy. Individuals have access to an overwhelming amount of health related information that may be difficult to understand or incorrect. This impacts their ability to make informed health decisions, affecting their health and the health of communities. Some strategies that health professionals can employ to combat this are showing the public that they care, focusing on what people need to do instead of explaining the science behind it, and using simpler phrasing and terminology. Ultimately, healthcare professionals have an obligation to do their part to help address the “infodemic” and low health literacy. It is in the best interest of everyone for individuals to make well-informed decisions that impact their own health.