Achieving a Future of Global Health Literacy

Health literacy measures how people access, understand and apply health information to their lives. Though the description is simple, the process of promoting health literacy becomes complex when applied to the global population. While the goals of promoting health literacy are clear — being that people should have equitable access to and understanding of health information — the means of reaching a future with proficient, worldwide health literacy are not so easily established. 

To examine where health literacy fits in on a global scale, we can start by looking at goals that already exist. The United Nations 2030 Agenda for Sustainable Development includes 17 goals for member countries to pursue over the next 13 years. These objectives call on participation from governments around the world to address the complex needs of the global population, and they specifically target poverty and inequality.

While each of the goals requires cross-sectoral mobilization from public health, education, climate change, government and social institutions, seven of the 17 sustainable development goals can be directly influenced by the promotion of health literacy, according to the World Health Organization:

  • No poverty
  • Zero hunger
  • Quality education
  • Decent work and economic growth
  • Industry, innovation and infrastructure
  • Reduced inequalities
  • Peace, justice and strong institutions

WHO emphasizes health literacy as a means to promoting equity and equality in global health, but the need to establish actionable strategies requires communication among institutions with the resources to create realistic and timely measures. So how exactly do we turn big ideas into intentional and focused efforts? Nursing@USC asked experts in the public health space to answer the question:

How would you promote global health literacy on the ground and why?

Educate girls on the value of health and health approaches that are specific to them and their community. Build a culture of gender equity and trust. Provide role models and local mentors, such as caring and compassionate nurses, to encourage self-worth and mastery. This will translate to their future families, but only if we can address basic needs at the same time. It’s hard to focus on and retain health messages if one is struggling with homelessness or hunger or poverty or gender-based violence. 

—Carole Treston, RN, MPH, ACRN, FAAN, Chief Nursing Officer, Association of Nurses in AIDS Care

Provide written information to parents in a fashion that is understandable at a sixth-grade level, has plenty of graphics and white space, and answers common questions.

—Deborah J. Pontius, MSN, RN, NCSN, FNASN, National Association of School Nurses

“The more you know, the better you heal” was long the motto of the Friends of the National Library of Medicine of the National Institutes of Health. It provides a simple frame for an often overlooked challenge worldwide. Surveys show that people place the most trust in nurses and other health care and public health professionals to help them heal, so it is only logical that those same professionals can help improve global health literacy. There is a growing body of literature to consult on this challenge, including a useful roundtable on health literacy from the National Academies of Sciences, Engineering and Medicine. By simply committing to a greater level of civic engagement, scientists and health professionals can do a great deal to help others understand how scientific evidence impacts everyone’s quality of life.

—Mary Woolley, President and CEO of Research! America

 I would provide education and access to technology, such as iPads, for those with communication disorders such as aphasia, cerebral palsy, autism and more. Communication is essential to quality of life. 

Kate Kelleher, Speech Language Pathologist, Western Carolina University

 GACD has a wide range of projects that investigate ways to prevent noncommunicable or lifestyle-related diseases. For example, we use video and social media campaigns in Peru to advise on reducing salt, and promotional educational materials in primary schools in China to educate the older members of the family on exercise and salt reduction.

—Rosie Bartlett, Communications Manager, Global Alliance for Chronic Diseases

 I would work with community members to understand the needs and available resources in that community. Alternatively, I would work with community members to develop the resources to improve access to health information. Improving access to health information must involve listening and working together. 

—R.V. Rikard, PhD, Senior Research Associate, Michigan State University

Educate your audience enough that they can make decisions and think about their health and that of their families. It’s a long-term ask, but the most likely to yield true results. Put the information where it makes sense and where they can actually translate it into action.

—Susana Oguntoye, Director of Monitoring, Evaluation and Knowledge Learning, Africare

While these ideas only cover a few of the venues for promoting health literacy, they are a start to the necessary and ultimately lengthy conversation about strategies that will foster change. A few themes are evident in the beginning of this discussion, namely education and innovative communication strategies. Accessing information is traditionally a two-way street, but that becomes more complicated when factoring for social determinants like language proficiency, digital mediums and geographic limitations.

Medical providers, educators and social workers must look to identify these environmental factors when creating and disseminating health information for patients and their families. Providers can anticipate the need for in-depth and repeated dialogues about patient care, but they also must make information easier to understand. Writing at lower reading levels and in multiple languages will help more people comprehend health information. It’s also necessary to consider where and how to distribute information so that more people can access it.

Another way to promote health literacy is supporting gender equality. Advocating for girls to receive education is a step toward empowering women to take care of their personal health. Educational tools for nutrition, disease prevention, sanitation and reproductive health help women apply health information to their lives and improve the health of their families and communities. Investing in girls’ education is a long-term, yet powerful way to bring health information and practices to more people — especially in communities where women are traditionally seen as caretakers.

Internalizing health information renders people more likely to maintain preventive care in the long run, which highlights the need for patient-provider communication that builds the skills for patients to continue healthy habits long after they leave a clinic or hospital. This points to long-term, proximal access to disease prevention and reproductive health resources, as well as regular clean water and sanitation supplies. Families living in impoverished communities are not only less likely to have access to these resources but more likely to encounter social determinants — environmental factors such as jobs, housing and transportation — that make them more susceptible to disease, violence and other threats to health and well-being.

Ultimately, identifying the social determinants that affect patients can pinpoint areas that will be the most effective for promoting health literacy from the ground up, like women’s education, digital literacy and proper housing facilities. When people are given the necessary tools to make health decisions, they are more likely to make better long-term decisions, while encouraging others to do the same.