Building on research evidence to change health literacy policy and practice in England

Abstract

Background

Health literacy is important because of the high proportion of the population with skills below those needed to become and stay healthy, and the resultant negative impact on people’s lives. A recent study in England has shown that, as is true in other industrialized nations, a significant proportion of people (43–61%) have literacy and numeracy skills below those needed to fully understand and use health materials. This paper describes a project designed to build on these findings with key stakeholders to develop an action plan to address a mismatch between population skills and the health system complexity.

Method

The multi-stage project involved an initial meeting of stakeholders that allowed participants to share knowledge and experience, and make suggestions for change. Subsequent web-based surveys enabled widening of the stakeholder group, identification of further potential actions, and participant rating of the impact of the suggested actions on this mismatch. Next, a meeting enabled the group to identify priorities for change that would be feasible and cost-effective.

Results

Forty-one participants were recruited from a range of patient, health, lifelong learning, civil service, and industry perspectives. Suggested topics for action fell into four areas; improving health services, building health literacy skills in the population and workforce, recognizing the importance of public information developed outside the health arena, and funding for health literacy research and development. Following consideration of likely cost, impact, and feasibility, five suggested areas were prioritized for action, three involving improvements in the health service, and two involving the development of public health literacy skills. The importance of inter-sectoral approaches to this complex issue was identified.

Discussion

This project recruited key stakeholders with a wide range of relevant expertise and perspectives. It resulted in a clear, coherent action plan to address the population skills: health system complexity mismatch. Next steps include implementation, evaluation, and widening to other areas of life important to public health and well-being such as public safety messages and social care.

Keywords:

• Health literacy
• Health service
• Health system organization
• Patient education
• Policy

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Errata

Additional information

Notes on contributors

Gillian Rowlands

Gillian Rowlands is a family physician and health literacy researcher. She founded, and now co-chairs, the Health Literacy Group UK (www.healthliteracy.org.uk). She has authored and co-authored over 50 peer-reviewed publications and co-edited a book ‘Health Literacy in Context: International Perspectives’.

Jonathan Berry

Jonathan Berry is the director of a national voluntary health literacy organization, the Community Health and Learning Foundation. In a previous role as executive director for health and well-being for the charity, ContinYou, he managed the national health literacy programme, Skilled for Health, on behalf of the government.

Joanne Protheroe

Jo Protheroe is a senior lecturer in General Practice and a GP. Her research is focused on two NHS priorities – the needs of socio-economically disadvantaged patients and the need for interventions to improve patient self-management in long-term conditions. She is a co-chair of the Health Literacy UK group.

Rima E. Rudd

Rima E. Rudd is a senior lecturer in Health Literacy, Education, and Policy at the Harvard School of Public Health. Her teaching, research studies, and policy activities are focused on health disparities and literacy-related barriers to health. Her reports helped shape national and international health literacy research policy agenda. She has received national and international awards for her work.