National Rural Health Day Essay Contest - Center for Rural Health

As you consider a future in healthcare, it’s important to understand and recognize the impact healthcare providers and staff have on delivering health information that is truly understood by patients. The definition of health literacy was expanded upon a few years ago and is now redefined by the U.S. Department of Health and Human Services as follows: 

Personal health literacy is the “degree to which individuals can find, understand, and use information and services to inform health-related decisions and actions for themselves and others.” (1)

Personal health literacy refers to the skills necessary for a person to participate in the health care system and maintain good health. These skills include reading and writing, calculating numbers, communicating with healthcare professionals, and using health technology. 

But health literacy is a two-way street. The burden of limited health literacy should not lie solely on the individual. Healthcare organizations can adopt strategies to address health literacy and make it easier for people to use their services. (2)

Organizational health literacy is the “degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.” (3)

Who has Limited Health Literacy? According to the Center for Healthcare Strategies, Inc., “only about one in 10 English-speaking adults in the U.S. has “proficient” health literacy skills. Among the nine, about half have “intermediate” health literacy skills, and a little over one-third have “basic” or “below basic” health literacy skills.  

Limited health literacy can worsen health outcomes, strain the healthcare system, and create additional costs. It disproportionately impacts Medicaid members. Sixty percent of people with Medicaid coverage are either at “below basic” or “basic” health literacy levels, compared to only 24 percent of those with employer-sponsored coverage.

Limited health literacy makes navigating healthcare systems difficult for some people and very difficult for others. This especially includes:

• People ages 65 and older;
• Those living at a low socioeconomic status, income level, or education level;
• People who identify as Latino, Black, or American Indian/Alaska Native;
• People with limited English proficiency and/or non-native speakers of English; and
• Those insured by Medicaid or Medicare, or who are uninsured.

Why is Health Literacy Important? The Center for Disease Control best summarizes it: “Health literacy is important for everyone because, at some point in our lives, we all need to be able to find, understand, and use health information and services. 

Taking care of our health is part of everyday life, not just when we visit a doctor, clinic, or hospital. Health literacy can help us prevent health problems, protect our health, and better manage health problems when they arise.

Even people who read well and are comfortable using numbers can face health literacy issues when:

• They aren't familiar with medical terms or how their bodies work;
• They have to interpret statistics and evaluate risks and benefits that affect their health and
  safety;
• They are diagnosed with a serious illness and are scared and confused;
• They have health conditions that require complicated self-care;
• They are voting on an issue affecting the community's health and relying on unfamiliar
  technical information.”

Health literacy is also a health equity issue. Populations with limited health literacy skills disproportionately experience adverse health outcomes and poorer access to quality care. These inequities can reinforce one another. Race and ethnicity, age, primary language spoken, education level, and socioeconomic status all influence the prevalence of limited health literacy. (4)

Health literacy is an organizational and health system issue. The Centers for Medicare & Medicaid Services and the Department of Health and Human Services both list improved health literacy as organizational priorities. Healthcare organizations that do not prioritize health literacy will face challenges in providing high-quality, equitable care. (5) (6)

Limited health literacy can result in the following: 

• Medication errors;
• Difficulty understanding and following care plans;
• Reduced use of preventive services;
• Challenges managing the complexities of chronic conditions;
• Longer hospital stays, increased hospital readmissions, and increased emergency
  department use
• Confusion about appropriate responses to public health emergencies; and
• Higher mortality.

Finally, the Center for Health Care Strategies indicates that health literacy is a cost issue. Limited health literacy, through all its impacts—medical errors, miscommunication, increased illness and disability, loss of wages, and compromised public health—is estimated to cost the U.S. economy up to $349 billion every year, when adjusted for inflation to 2023 dollars using the Bureau of Labor Statistics CPI Inflation Calculator.

Essay Question: Identify three ways you believe healthcare professionals can address health literacy. (Research the facts, define the issue, and communicate a clear and compelling story of what should be done and why.)

Resources:
1. Healthy People 2030. History of health literacy definitions. (n.d.)U.S. Department of Health and Human
Services. https://health.gov/healthypeople/priority-areas/health-literacy-healthy-people-2030/history-health-literacy-definitions
2.  Brach, C., Dreyer, B., Schyve, P., Hernandez, L.M., Baur C., Lemerise, A.J. & Parker, R. (2012, January 12). Attributes of a health literate organization. NAM Perspectives [Discussion paper]. National Academy of
Medicine. https://doi.org/10.31478/201201f 

3. Centers for Disease Control and Prevention. (2020, August). What Is Health Literacy? U.S. Department of Health and Human Services. https://www.cdc.gov/healthliteracy/learn/index.html 
4. Center for Health Care Strategies. (March, 2024) Fact Sheet. https://www.chcs.org/resource/what-is-health-
literacy/ 
5. Centers for Medicare & Medicaid Services. (2022, April). Framework for health equity, 2022-2032. U.S.
Department of Health and Human Services. https://www.cms.gov/files/document/cms-framework-health-
equity.pdf 
6. Healthy People 2030. Healthy People 2030 framework. (n.d.) U.S. Department of Health and Human
Services. https://health.gov/healthypeople/about/healthy-people-2030-framework 

*Please note, the registration process and essay submission is designed to take place all at once. Applicants will be unable to save and retrieve information if they are interrupted or unable to complete their registration and essay submission during one login session. Applicants are encouraged to write and save their essay separately in a Word document and then upload their work once they are ready to complete the registration and essay submission process*

Winners will be announced on Thursday, November 21