Health literacy training is the best prescription for everyone

Ludmilla Wikkeling Scott explains why medical professionals, patients and non-patients should have health literacy training

Low health literacy can cause the overuse of health care due to a misunderstanding of services. Stephen Lock / The National

Health literacy has become a regular topic in public health circles over the past decade. Yet, in the UAE, which has been challenged by high rates of chronic disease, there is little mention of it as an integral component of treatment and prevention programmes.

The over-use of health care resources is a major concern. Health care providers report that, too often, patients see several specialists at the same time, visit the emergency room for non-emergency medical issues, and receive more than just a second opinion on diagnosis.

Patients may suffer chronic disease but are not following instructions on care upon leaving the medical office.

News outlets and social media are filled with advice on health and wellness and yet the plethora of information does not seem to have a significant effect on behaviour change. Nor does it seem to put a dent in the alarming numbers of people diagnosed with obesity and diabetes-related cardiovascular disease. So what is the role of health literacy in all this?

The World Health Organisation defines health literacy as “the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health”.

The immediate assumption is that health literacy has to do with educating the public. Not exactly. WHO cautions us that it means more than being able to read pamphlets and successfully make appointments, it is about improving people’s access to health information and their capacity to use it effectively. It is critical to empowerment because it requires individuals to have a more active role in decisions and management.

Low health literacy can cause the overuse of health care due to a misunderstanding of services. Language barriers may exacerbate this issue, considering that a large number of health care providers in the UAE are fromnon-Arabic-speaking countries. A patient may have some knowledge of English or the provider may speak fluent Arabic and yet the patient still does not understand instructions for self-care.

Health care providers and staff may also overestimate their ability to use the right terminology to provide patients with instructions, because they believe they speak the patient’s language.

This makes it difficult to figure out whether the patient really understands the information they have received and whether the provider recognises that the patient has a limited understanding of what is being conveyed. If a patient cannot ask the right questions, this interferes with the level of care received.

Cultural differences can significantly influence treatment and care due to miscommunication between the health care provider and patient. Limited trust further adds to the challenge and lowers the chance for a provider to get a true picture of the patient’s health profile.

Some patients rely on family members or friends to take them to a clinic or hospital, so it is important that health care providers and patients recognise the role of social support.

We are flooded with wellness information through many printed materials and the internet. However, access to such material does not necessarily mean that everyone has the cognitive and social skills to process the information in a meaningful way.

In a region of tremendous diversity and high rates of chronic disease, it would be of great benefit to assess the health literacy of the population  in order to further health policies.

Health literacy in medication use should be explored beyond the need to increase the use of generic versus brand name medication. It should include patient adherence to medication and management of medication routines.

It is important that  health literacy programmes meet the population where they are and not where they perceive them to be.

Medical professionals, patients and non-patients should have health literacy training.

Evidence-based practices in health education and health promotion may prove to be of great benefit in moving the UAE towards a healthier population. It is the key to healthier outcomes.

Dr Ludmilla Wikkeling Scott is an assistant professor of public health and environmental sciences and sustainability at Zayed University