People must have particular personality traits and social resources, also known as health literacy, in order to access, comprehend, and use information to make decisions about their health. Patients’ ability to engage in complex disease management and self-care is strongly related to their level of health literacy. It can help us stay healthy by preventing illness and effectively managing existing illnesses. People with low health literacy (LHL) may find it difficult to manage their condition and prevent illness, which may lead to increased use of healthcare services. Furthermore, LHL is associated with increased hospitalizations, increased use of emergency care, decreased use of preventative services, and a worsened ability to understand labels and health messages, a worsened state of health, higher mortality, and more expensive medical care.
Health literacy is heavily influenced by a country’s medical practices, as well as individual and social factors present in interactions between people and the systemic demands of the healthcare system. LHL is most frequently linked to older people with chronic illnesses who have little education and are not necessarily from lower socioeconomic backgrounds. Also, socioeconomically disadvantaged people, those who belong to ethnic minorities, or people with higher psychological distress, physical limitations, poor social support, compromised mental health and quality of life are contributors of LHL. Around the globe, LHL prevails mostly with people living in rural areas and having a low education level. Surprisingly, LHL prevails among half of the population in both developing and developed countries.
People with LHL may have 1.5-3 times the number of serious health outcomes, such as higher mortality, hospitalization rates, and disease management ability, as those with adequate health literacy. LHL is not uncommon among patients with a high level of education or with well-off patients. Moreover, patients with LHL, but with high education, had a higher probability of emergency department (ED) re-visits. Empirical research based on a conceptual model estimated that LHL costs between 7 and 17% of total healthcare expenditures. According to patient-centered interventions, improving health literacy can reduce the risk of polypharmacy, medication non-adherence, and healthcare costs. Mistrust and LHL were linked to high levels of vaccine hesitancy, providing evidential support for portraying these factors as perceived barriers to COVID-19 vaccine uptake. Also, LHL is linked to gestational diabetes, maternal stress and depression, low birth weight, stillbirth, and congenital malformations during pregnancy and birth, all of which have negative consequences for the woman and her child.
LHL is a prevailing problem in Europe, Asia and Africa. Bulgaria, Lithuania and Latvia are the 3 European countries with lowest health literacy, prevails among close to 75% population. LHL represents nearly 50% of Germans. Also, every fourth to fifth person is not immunized against COVID-19 in Germany. Health literacy among the population is expected to rise over time in this era of modernization. According to a national survey conducted in the Czech Republic in 2015-16, nearly 60% of Czechs have LHL. Surprisingly, a 2018 survey revealed that health literacy in the Czech Republic was still declining.
The global economic cost of illiteracy is estimated to be $1.19 trillion, but LHL alone costs the US economy $238 billion per year. Only 12% of Americans have adequate health literacy, and improving health literacy could prevent nearly 1 million hospital visits and save more than $25 billion per year, according to the US Centers for Disease Control and Prevention (CDC). Surprisingly, close to 40% of US and UK adults have LHL, compared to around 50% of Europeans, 60% of adults in Canada, Australia, and the UAE, and nearly 70% of Chinese.
In China, health literacy increased from 6.48% of the population in 2008 to 23.15% in 2020. However, only 1 in 5 military health providers of the Chinese People’s liberation Army had adequate health literacy, found in a recent survey published in BMC Public Health.
Menstruation is fraught with taboos, restrictions, and misconceptions in low- and middle-income countries, especially in India and sub-Saharan Africa. In India, nearly 80% of menstruating girls and women use an old cloth that is frequently reused. Further, around 90% of women in India sometimes resort to using ashes, rags, sand, newspapers, dried leaves, wood shavings, hay, plastic and husk sand to aid absorption. Additionally, these two areas are home to more than 90% of the world’s open defecation practitioners. Many superstitious Indians hold the view that defecation is an impure act that should only be performed outside the home and that toilets should only be used in inclement weather. It is not surprising that at least 90% of Indian adults have poor health literacy.
LHL contributes significantly to the healthcare system’s incompetent socioeconomic culture. Health issues are not only overlooked but also neglected. It reflects how much health and wellbeing are overlooked in a community or country. Economic conditions should not be condemned because they persist in developed countries as well. LHL has grown to unbearable proportions all over the world. Reading, listening, analytical, and decision-making skills, as well as the ability to apply them to health situations, are all components of health literacy. Literacy can only be improved through health education, which necessitates multifaceted approaches. Many members of the health care team lack health literacy training, are unaware of ways to improve communication, and forget to use effective communication practices on a regular basis when providing care. Health care professionals require assistance and training to better understand health literacy and how to address it through clear communication strategies. Customized patient education, on the other hand, engages, motivates, and strengthens patients to participate in their own health care and treatment decisions, resulting in better outcomes, fewer diagnostic tests, and significantly greater patient satisfaction.