Healthy People 2030 describes two components of health literacy ─ personal health literacy and organizational health literacy. Individual health literacy is defined as “the degree to which individuals have the ability to obtain, understand, and act upon health information and services needed to inform health-related decisions and actions for themselves and others.” Organizational health literacy is defined as “the degree to which organizations equitably enable individuals to find, understand and use health information and services to inform health-related decisions and actions for themselves and others.”
Despite the attention given to health literacy by the federal government over the last several decades and the research within the field, most organizations today are not health literate organizations. The lack of organizational resource allocation for building health literacy expertise and diffusion is partially fueled by the gaps in health literacy research. As an example, The Joint Commission rejected a proposal from the National Council to Improve Patient Safety Through Health Literacy, to elevate health literacy to a national patient safety goal because there is “limited evidence that interventions to address health literacy improve quality and safety.”
Many research studies have found an association between limited health literacy and:
- More frequent ED visits,
- Hospitalizations and readmissions,
- Poor medication adherence, and
- Lower rates of preventive care services.
However, less is known about the specific components of health literacy interventions that result in successful, replicable, and scalable improved patient outcomes. Research is lacking in establishing a causal relationship between health literacy interventions and desirable health outcomes as these studies are high cost requiring RCTs and comprehensive patient population data.
Healthcare experts and researchers have cited the need for high quality, implementation research to inform interventions that are effective for mitigating limited health literacy. Studies are needed to assess the effectiveness of processes and products in health care that have been reengineered using health literacy best practices.
More research is needed evaluating the organizational health literacy guides for applicability and effectiveness in practice. Rigorous research linking such practices as teach-back and clear patient communication to a reduction in hospital readmissions is needed to facilitate broad adoption by managed care and hospital systems. There is a need to explicate the pathway from improved provider communication using health literacy principles, leading to increased patient trust in the provider, leading to increased patient engagement and uptake of preventive screenings and vaccinations. This may result in decreased avoidable hospitalizations and late-stage cancer diagnoses.
Importantly, there is also a need for research that links improvements in health literacy with a reduction in health disparities. Public health information that is not understandable and actionable by at least a third of the population serves to continue the historically embedded practices that lead to wide-spread health inequities. Adaptations of patient education and information for web and patient portals must be studied to ensure such practices do not further increase health disparities and inequities.