Re-posted from Health Literacy Policy Briefing March 2015 by http://www.chlfoundation.org.uk/
Health Literacy – the agenda we cannot afford to ignore
A joint briefing from the Community Health & Learning
Foundation and the Health Literacy Group UK March 2015
This briefing provides an overview of the important agenda
of health literacy and outlines the extent of the level of need and its
economic impact. It concludes with four key priority policy actions. It is a
key point summary of a longer policy briefing from the Community Health &
Learning Foundation.
What is health literacy?
The World Health Organisation definition is: ‘… the
achievement of a level of knowledge, personal skills and confidence to take
action to improve personal and community health by changing personal lifestyles
and living conditions. Thus, health literacy means more than being able to read
pamphlets and make appointments. By improving people’s access to health
information, and their capacity to use it effectively, health literacy is
critical to empowerment.
Health literacy is central in the complex links between
health inequalities, income and skills and is critical to inclusive growth for
local and national policy as the economy moves out of the recession. It
recognises a shared responsibility between government, local institutions,
employers and people in addressing the socio/economic factors that impact on
health.
The scale of the problem
Recent research on the mismatch between the population’s
health literacy and the skillsiii needed to navigate and understand the system
shows that 43 per cent of people aged 16 – 65 are unable to effectively
understand and use health information, this rises to 61 per cent if maths is
involved. This means that between 15 and 21 million people of the working age
population in England may not be able to access the information they need to
become and stay healthy. This is significantly higher than those who lack basic
literacy and numeracy skills and highlights the multi-dimensional nature of
health literacy The economic implications Low health literacy is expensive.
American research shows that the cost of poor health literacy is between 3-5
per cent of the health budget a yeariv . It found that at a patient level the
additional expenditures per year for each person with limited health literacy
as compared to an individual with adequate health literacy range from $143 to
$7,798. In England, the NHS budget is £95.6 billionv - a 2 saving of 3-5 per
cent from effective health literacy would be in the range of £2.87 billion to
£4.78 billion.
Implications for the NHS
Low health literacy
leads, among other things, to widening health inequalities, patients not
understanding written information, patients not understanding what health
practitioners tell them, patients not adhering to medication instructions, people
not being able to follow healthy lifestyle advice and patients being passive
recipients rather than active partners in their care. This, in turn, has
significant clinical and financial impacts e.g. patients by default going to
A&E (cost £111 per visit) or dialling 999. An emergency ambulance call
costs an additional £455. In comparison, a GP attendance costs £32.
What needs to change?
Health literacy is a complex issue and needs collaborative
cross-sectional approaches, particularly between the health and learning
sectors. At the Community Health & Learning Foundation and the Health
Literacy Group UK we have identified three priority actions needed at a
national and local level to ensure effective health literacy:
· a
cross-government strategic approach to recognise the economic and social impact
of health literacy and its role in addressing health inequalities and
wellbeing;
· the
integration and adoption of health literacy as a core literacy within education
and skills policies;
· the
development of a health literate system with clinical commissioning groups
prioritising practitioner awareness.
World Health Organisation (1998) Health Promotion Glossary:
http://www.healthliteracypromotion.com/upload/hp_glossary_en.pdf
For a detailed discussion see Benzeval M et al. (2014) How
does money influence health? JRF
http://www.jrf.org.uk/publications/how-does-money-influence-health iii Rowlands
et al (2012)
Defining and describing the mismatch between population
health literacy and numeracy and health system complexity2014 submitted for
publication – a note of interim findings available at
http://www1.lsbu.ac.uk/php5c-cgiwrap/hscweb/cm2/public/news/news.php?newsid=115
iv Eichler, K., Wieser, S., Brugger, U. (2009).
The costs of limited health literacy: a systematic review.
International Journal of Public Health,
http://www.springerlink.com/content/n7327r1tl81665t3/fulltext.pdf v
http://www.england.nhs.uk/allocations-2013-14/
