Poor health literacy: a societal problem

This blog was written by Libby Whittaker from the Self Care Forum

Poor health literacy detrimentally affects individuals, families, society and health systems. 

The Self Care Forum, which is a charity, was established in 2011 to ensure that the issue of poor health literacy, and the lack of effective support for self care were brough to the attention of relevant decision makers.  We also work to support people-facing organisations to find solutions which promote the health and wellbeing of people in their care.

For many years, we have been an advocate for increased levels of health literacy, with a special focus on health education taught in schools.  It is crucial that future generations understand how to take care of their minds and bodies, and know what to do, and where to go, if they feel something is wrong. 

Why is health literacy so important?

Currently, four in 10 of us struggle to read health information, this number increases to six in 10 when the health content has numbers.

People with low levels of health literacy tend to:

• have unhealthy lifestyles and poor general health,
• tend not to take advantage of screening or vaccination services,
• have difficulty in taking medicines correctly,
• make repeat visits to A&E and are hospitalised more often,
• have reduced life expectancy.

According to the NHS, health literacy accounts for up to 5 per cent of national health spending, this will amount to £10.6bn in England this year.

There is also a clear link between socio economic status and health literacy, making it a health inequalities issue too. 

Is illiteracy the same as poor health literacy?

Poor health literacy must not be confused with poor education or being illiterate. Even people with strong literacy skills can face health literacy challenges, such as:

• being unfamiliar with medical terms, or how their bodies work,
• interpreting numbers, or equating risk and benefits, to decide about their health,
• being scared or confused when diagnosed with a serious illness,
• suffering multiple health conditions requiring complicated self care.

Low levels of health literacy not only reduce people’s ability to self care, but also result in individuals not knowing who best to seek help from if they do have a problem.  Indeed, although there is widespread love and support for the NHS, knowledge about how it works is poor. In addition, many people find it difficult communicating effectively with their health professionals, and consequently, are unable to make the best use of the advice they are given or contact the most appropriate person in the first place.

GPs often report that much of their consultation time is taken up with simple health education messages and ensuring their patients know exactly what to do.

The need for effective health literacy is essential if we are to “look after ourselves” properly.

What can we do to improve levels of health literacy in the population?

Sadly, a decade on from founding the Self Care Forum, the issues caused by poor health literacy are still pervasive, because there is no simple or quick fix.  

In the long term, the best solution is for health education, with a focus on self care, to be taught in schools, including knowledge about how the NHS works and how to access it.  There is no doubt that this will help to support the health of future generations.

Teaching schoolchildren about our health system will also spark an interest in NHS careers and foster a lifelong value and respect for our health service. 

In the meantime, there is a great deal happening to increase levels of health literacy. Initiatives are being implemented up and down the country.  The Self Care Forum’s Coronavirus Innovation Awards in 2020 brought to light some truly remarkable work taking place.  But more needs to be done, and on a much bigger scale.

Self Care Week, organised by the Self Care Forum, has provided an excellent hook for local organisations to collaborate on innovative self care initiatives to help their communities.  More than 900 organisations and individuals took part in 2020 to raise awareness of how people can take better care of their own physical health and mental wellbeing.  And each year participation increases, which is encouraging.

As primary care structures in England change again, the hope is that these new local networks with a focus on integrated solutions, will provide more opportunity for collaborative working to support their population’s ability to look after their own health.

Initiatives such as “Make Every Contact Count” driven by NHS England and NHS Improvement, and NICE Guidance on Shared Decision Making, provide a framework for ensuring each interaction within the health system is empowering for the patient.  Our own Self Care Aware Consultation course, which was first developed in 2011, has these principles embedded too.

In the last ten years of the Self Care Forum, we have seen a gradual drive within many communities to help people to help themselves in relation to their health and wellbeing.  However, this needs to be accelerated if we are to combat the disparity between different parts of the country, which contributes to the increasing levels of health and social inequity in our society.