One Step You Can Take to Improve Health Literacy

Healthwise Communications Team


Ellen had a rash on her forehead. She thought maybe she got it from working in the garden that morning. Ellen put some aloe vera cream on the rash, but it didn’t seem to help. Then, a few days later, her eye started to hurt. When Ellen’s eye started to turn red and her vision blurred, she called an ambulance. The emergency room doctor quickly realized that Ellen had shingles in her eye and put her on an antiviral medication. Although Ellen’s shingles cleared up, she still has nerve pain and a big emergency room bill. She was shocked to hear that what started as an annoying rash could have caused her to go blind in that eye.

Ellen hadn’t been to the doctor in years. She used to have annual checkups, but she fell out of the habit. Had Ellen been going to the doctor regularly, her doctor would have recommended the shingles vaccine since she’s over 50 years old. If she had been better connected with her doctor, she would have received health education explaining what shingles is like, allowing her to recognize her rash and feel more comfortable contacting her doctor early on. Or she may have gotten the vaccine and avoided shingles—and her hospital bills—altogether.

Ellen’s story isn’t uncommon. Across the country in both rural and urban areas, among the educated and uneducated, low health literacy is a challenge. Health literacy doesn’t just refer to someone’s education level or reading ability—it also describes the skills a person needs to stay healthy. Skills like using health technology, navigating the health system, and being able to communicate with health care professionals are all part of health literacy. How big a problem is low health literacy?

Low health literacy costs a lot

More than one-third of U.S. adults have low health literacy. Compared to those with proficient health literacy, adults with low health literacy experience:

  • 4 times higher health care costs.
  • 6% more hospital visits.
  • 2-day longer hospital stays.

And low health literacy isn’t just a problem for patients who don’t get the care they need—it’s a problem for health care organizations. Low health literacy is estimated to cost the U.S. $236B annually. Yes, that’s billion with a “b.”

Low health literacy stems from innumerable factors, making “solving” it seem as impossible as achieving world peace. There’s no silver bullet, but there are some things that can help. Quality health education is one piece of that puzzle.

A clinician educates a patient and child


How health education can improve health literacy

The U.S. Department of Health and Human Services released an action plan to improve health literacy, and their stats present a dire picture of available health information: Nearly 9 out of 10 adults have difficulty using the everyday health information available to them.

Health education in its most basic form should help people understand their health. Someone who doesn’t understand a condition or diagnosis probably won’t understand or be able to manage their treatment, leading to poor outcomes and higher health care costs. If Ellen had been visiting her doctor regularly and received health education explaining the vaccine or what a shingles rash looks like, she could have avoided a health scare, ongoing pain, and emergency room bills.

Improving a person’s understanding through health education can have other positive effects:

  • Health education improves comprehension.

    The best health education explains conditions and treatments in plain language, written at an accessible reading level. When health education is designed to meet the needs of underserved people, the education improves health literacy for everyone.

    Patient instructions (handouts meant to teach patients specific knowledge or skills) in visual formats can make information even more accessible. By eliminating extra text and using images wherever possible, these patient instructions are boiled down to their easiest-to-understand form. This helps patients follow instructions and participate in their own care for better outcomes.
  • Health education improves communication.

    Health literacy is strongly associated with helping patients engage in their own health management or self-care. Offering patients the right education tools not only helps them understand their health but also helps them have a voice in their care journey. Part of that is knowing when and how to communicate with clinicians. Health education can help patients understand when a condition merits a call to the doctor or a visit to the emergency room, preventing unnecessary visits but also helping patients get the care they need when they need it. And health education like decision-making tools gives patients the knowledge they need to have input on their care and increases their trust in their clinicians.
  • Health education improves health equity.

    Much like health literacy, health equity is a huge issue in health care. Everyone should have the chance to be their healthiest, but there are countless racial, economic, environmental, and social conditions that make health care inequitable. Again, there’s no silver bullet, but health education can help.

    Although low health literacy is spread across many populations and demographics, it’s strongly associated with non-medical attributes like speaking English as a second language and having lower education levels. These underserved populations also likely experience low health equity.

    Providing accessible health education is one small step to leveling the playing field. Health education that includes images of diverse skin colors and body types, is written in plain language, and includes visual instructions helps address comprehension. These criteria also ensure that the education meets National Committee for Quality Assurance (NCQA) Standards.

For Ellen, familiarity with her doctor and education about conditions like shingles would have helped her get treatment for shingles much sooner. This would have saved her stress and health issues, as well as saved both her and the health care system money. Healthwise aims to provide everyone with the education they need to achieve their best health, including visual patient instructions and tools to help decide when and how to access care. Contact us for more information on how our health education can help you and your patients achieve better health literacy and reduce costs.