The importance of health literacy is acknowledged in Australia and has previously been discussed on this blog. According to the ABS (2006) only 48% of females and 43% of males aged between 15 and 44 had health literacy of level 3 (adequate) or above. This dropped to 32% and 35% respectively of those aged over 45.
According to the Canadian Expert Panel on Health Literacy: “Health literacy is the ability to access, understand, evaluate and communicate information as a way to promote, maintain and improve health in a variety of settings across the life-course.”
It strikes me that, by this definition, in achieving better health literacy in Australia we may improve health outcomes, equity of access and service efficiency. Hence my interest in the recent addition to the literature on this space from the Institute of Medicine, Integrating Health Literacy with Health Care Performance (DeWalt, D and McNeill, J, 2013).
This discussion paper is based on the American system of health care delivery and proposes the introduction of performance measures across the four levels of the U.S. health service described by Berwick (2002):
“The experience of patients
The microsystems of care delivery
The organisations that house or otherwise support these microsystems
The environment of policy, payment, regulation, accreditation and training that shape organisational action”
The authors go on to provide discussion of potential measures and mechanisms for designing an evaluation system. While the challenges and potential pitfalls of measuring service approaches to health literacy are recognised in the paper, the conclusion that “ultimately we believe that increased adoption of health literacy related performance measures can accelerate our understanding of clinical interventions to improve patient outcomes” provides food for thought.
The paper is primarily aimed at the American market, however it does provide a prompt for those here in Australia who believe that improving health literacy could improve the health and wellbeing of Australians and the efficiency of our service provision. Organisations keen to improve the approach to health literacy may want to start measuring their approach more broadly, rather than concentrating only on outcomes of specific pilots at the point of service delivery.
Agree that more coordinated attention needs to be given to health literacy in Australia. Diabetes Australia has called for a national HL strategy — something which is long overdue, given the initiatives adopted in countries such as Canada and the USA. HL needs to be linked to other strategic frameworks, such as the national women’s and male health policies; the considerable relevance of HL to disease prevention is also crying out for systematic attention.