The National Health Literacy Action Plan: The Time Has Come for Action

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  • This article was downloaded by: [University of Florida]On: 04 October 2014, At: 06:35Publisher: Taylor & FrancisInforma Ltd Registered in England and Wales Registered Number: 1072954 Registeredoffice: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

    Journal of Health Communication:International PerspectivesPublication details, including instructions for authors andsubscription information:http://www.tandfonline.com/loi/uhcm20

    The National Health Literacy ActionPlan: The Time Has Come for ActionScott C. RatzanPublished online: 30 Aug 2010.

    To cite this article: Scott C. Ratzan (2010) The National Health Literacy Action Plan: The Time HasCome for Action, Journal of Health Communication: International Perspectives, 15:6, 575-577, DOI:10.1080/10810730.2010.507430

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  • Editorial

    The National Health Literacy Action Plan:The Time Has Come for Action

    SCOTT C. RATZAN

    I have spent my career working to improve public health around the world with avariety of activities. I have edited the Journal of Health Communication for 15 yearsas I have spanned academic, not for profit, governmental, and private sector as myprincipal employment.

    By now, it is clear that giving people access to care and medicines are only partof improving overall health as social determinants and evidence builds for multipleindicators that contribute to health.

    One of the most important determinants of health is health literacy. Can an indi-vidual navigate the system? Do they understand the instructions that the doctor ornurse has explained about their care? Do they have the basic tools to maintain ormodify their behavior? All of these aspects of how people interact with the healthsystem can ultimately determine if they are able to improve their health.

    A significant factor impacting the ability of individuals to follow medical guid-ance or make the changes needed to improve their health is improving peoplesunderstanding of health information.

    Limited health literacy affects people of all ages, races, incomes, and educationlevels, but the impact of limited health literacy disproportionately affects lowersocioeconomic and minority groups and underlies many of the disparities observedamong these groups. It affects peoples ability to search for and use health infor-mation, adopt healthy behaviors, and act on important public health alerts. Limitedhealth literacy is also associated with worse health outcomes and higher costs.

    Two decades of research indicate that todays health information is presented ina way that is not usable by most Americans. Nearly 9 out of 10 adults have difficultyusing the everyday health information that is routinely available in our health carefacilities, retail outlets, media, and communities (Berkman et al., 2004; Institute ofMedicine, 2004; National Library of Medicine, 2000). Without clear informationand an understanding of prevention and self-management of conditions, peopleare more likely to skip necessary medical tests. They also end up in the emergencyroom more often, and they have a hard time managing chronic diseases, such asdiabetes or high blood pressure.

    Health literacy is now the law of the land as the definition of the degreeto which individuals have the capacity to obtain, process, and understand basic

    Scott C. Ratzan, MD, MPA is Editor-in-Chief of the Journal of Health Communication:International Perspectives. He is also Vice President, Global Health, Johnson & Johnson.

    Journal of Health Communication, 15:575577, 2010Copyright # Taylor & Francis Group, LLCISSN: 1081-0730 print=1087-0415 onlineDOI: 10.1080/10810730.2010.507430

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  • health information and services needed to make appropriate health decisions isincorporated into The Patient Protection and Affordable Care Act, P.L. 111148,signed into Law by President Barack Obama on March 23, 2010. The Act notesits relevance to dissemination of research, prescription medication labeling, the edu-cation of health care providers, workplace wellness, and shared decision making.

    Given the documented challenges and impact on health outcomes, I was pleasedthat on the heels of health reform, the U.S. Department of Health and HumanServices Secretary Kathleen Sebelius announced, Health literacy is needed to makehealth reform a reality. In the release of the announcement of the National ActionPlan to Improve Health Literacy, Secretary Sebelius affirmed, Without healthinformation that makes sense to them, people cant access cost effective, safe, andhigh quality health services. But, HHS cant do it alone. We need payers and provi-ders of health care services to communicate clearly and make the necessary changesto improve their communication with consumers, patients, and beneficiaries.Todays plan is only the beginning of a long-term process with our many partnersin all sectors that we hope will result in a society that encourages people to livelonger, healthier lives.

    The National Action Plan to Improve Health Literacy was heralded as theresult of a decade of work by numerous public and private sector organizations andindividuals. The plan calls for improving the jargon-filled language, dense writing,and complex explanations that often fill patient handouts, medical forms, health websites, and recommendations to the public.

    Essentially the plan entails providing everyone with access to accurate andactionable health information, and supporting life-long learning of skills thatpromote good health.

    The summary of the plan provides a good sense of why this is important: thepromotion of health literacy is essential to the strength of America and othercountries around the world.

    Are essential tasks for promoting, protecting, and managing health clearlydefined, described, and communicated so that they are understandable and action-able? Is the use of technical jargon in electronic, written, and spoken communicationminimized? The overall objective is to align the required tasks and demands with theskills and ability of patients and consumers to build health literacy.

    Unfortunately, we currently have significant imbalance between the skills andability and the demands and task complexity. What do I need to know and do tostay healthy? When should I get screened for colon cancer? Should I be tested forosteoporosis? Why are instructions on my pill bottles different for the same medi-cine? Do the warning labels on my medicines really matter? What are the benefits,risks and potential side effects of this immunization or medicine?

    Not only has low health literacy been tied to poor health, but the economicconsequences of this silent epidemic are staggering with the costs of low health liter-acy estimated to be between $106 billion to $236 billion a year (Baur et al., 2010). Aswe face the challenges in the U.S. of simultaneously containing health care costs,improving quality, and expanding access, it is vital that we advocate for a systematicapproach to improving health literacy.

    Many of us in multiple fieldsfrom medicine to public health to communicationand educationhave worked closely with public and private organizations to getthis critical issue the attention it deserves. The work of many organizations andnow federal agencies also have collaborative efforts for the inclusion of an objective

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  • on health literacy in both Healthy People 2010 and Healthy People 2020. Theseobjectives can motivate multiple levels of intervention throughout America toimprove health literacy and public health.

    This Action plan includes opportunities for cooperation between the public andprivate sector as essential to the successful implementation of any health literacyplan. With this new opportunitywith the national dialogue moving forwardweall have the opportunity to leverage resources and expertise to assist HHS in theirefforts to improve the overall health of the nation.

    Finally, the Journal is dedicated to the advancement of health. With the fun-damental of ethical, evidence, and science based research, I also am proud that aSupplement to Volume 15 of the Journal includes articles on health literacy sup-ported in part by the Agency for Health Research and Quality. Furthermore,ongoing dialogue by the Institute of Medicine Roundtable on Health Literacy alsowill contribute to the possibilities this new action plan presents.

    All of us can start at home and work to help create an environment and systemsto make the nation more health literate. Health literacy will be critical to ensuring thatour health care system remains viable and continues to serve those in need of care.

    References

    Baur, C., Brooks, C., Harris, L., Locke, J., Neuhaus, C., Robinson, S., & Hilfiker, S. W.(2010). National action plan to improve health literacy. May 2010. Washington, DC:U.S. Department of Health and Human Services, Office of Disease Prevention andHealth Promotion.

    Berkman, N. D., DeWalt, D. A., Pignone, M. P., Sheridan, S. L., Lohr, K. N., Lux, L., et al.(2004). Literacy and health outcomes. Evidence Report=Technology Assessment No. 87(Prepared by RTI International-University of North Carolina Evidence-based PracticeCenter under Contract No. 290-02-0016). AHRQ Publication No. 04-E007-2. January2004. Rockville, MD: Agency for Healthcare Research and Quality.

    Institute of Medicine. (2004). In L. Nielsen-Bohlman, A. Panzer, & D. A. Kindig (Eds.),Health literacy: A prescription to end confusion. Washington, D.C., National AcademiesPress.

    National Library of Medicine. (2000). In C. R. Selden, M. Zorn, S. C. Ratzan, & R. M. Parker(Eds.), Current bibliographies in medicine: Health literacy. NLM Pub. No. CBM 2000-1.Bethesda, MD: National Institutes of Health, U.S. Department of Health and HumanServices.

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