Healthy literacy is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decision."
As you can see from this definition, there is no mention of ability to read. Health literacy is about more than being able to read. For instance, have you ever walked out of your doctor's office saying that you have no questions. But really, you're not sure how to take your new prescription, or why it is that you're being referred to a specialist.
Low health literacy can affect people of any race, age, income, or education level. Just because you know how to read, write, and speak a language, does not mean that you understand the issues related to your medical care. Doctors are not trained to speak at the patient's level, and when you are trained to use a certain language to speak about something, it's hard to feel like you are communicating the correct information if you don't use that language you were trained in. Basically, doctors, nurses, and health educators have a hard time letting go of words sometimes.
But outside of the medical realm, there are things that you read, hear, and process every day that affect your overall wellness.
For instance, all of the food you eat has an impact on your health. And virtually everyone knows that to be healthy you need to watch your calorie and fat intake. But does everyone know how to read a food label? Sure you may look at it and see the number of calories, but unless the serving size is the same size as the container, you have to do a little thinking about how much you can eat to take in that number of calories.
I was buying popcorn the other day, and I just started eating kettle corn. I wanted to see how many calories I was getting myself into though. I looked down, and thought, this is outrageous! How can lightly flavored popcorn have this many calories. I started to walk away, but decided to take a second look. I knew I had to be missing something.
As it turns out, I was looking at the number of calories that 1 cup of unpopped corn is. The popped amount was far smaller, and closer to what I expected. That's not to say that it got easy from that point on, figuring out the serving size was beyond what I felt like dealing with.
Now in all fairness, if I stop and think clearly about this popcorn label, it takes me about a minute to figure out what it all means. But what if you read at a 4th grade level? What if you have limited numeracy? Staying well in today's world is not as easy as many doctors and even health educators would have you believe.
Media literacy also impacts everyday health literacy. What I mean by this is, if you don't know how to decipher what is credible and what is bullshit in the media, your functional health literacy will likely decrease. You will likely fall for fad diets, or believe that a miracle pill will help you lose weight, or that a new supplement discovered in the jungle will cure cancer. And even if you wanted to go search for more information for yourself, do you know how to tell if a website it credible. And even if that website is full of credible information, will you feel overwhelmed by how little white space there is on the page or how many technical words are used.
I could go on, but I suppose my main concern stems from how incredibly simple and difficult it is to stay healthy in America. And in the public health field, all the attention going to health literacy is focused on the doctor/patient interaction. There is so much more to health literacy though, and only focusing on the medical side will not reach far enough.
Let's not condemn all who make the wrong choices, let's find ways to better present information so they can understand how to make the right choices. Let's put restrictions on health products and claims not reviewed by credible scientists. And let's integrate functional health literacy in to school curriculums.
If only it were so easy...
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