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Health literacy is critical to address health equity, improve outcomes

Brigham and Women’s Hospital prioritizes its readability program for patient-facing communications as a tactic to improve health outcomes.
By admin
Jul 6, 2022, 8:00 AM

How effective are your organization’s patient-facing communications? That’s a crucial question as providers deliver health information and service offerings intended to help patients and family members make appropriate care decisions. 

At the Health and Digital Literacy Convergence Summit, industry experts explained the importance of maximizing health literacy. As a starting point, according to the Centers for Disease Control and Prevention, patients with low health literacy: 

  • are more likely to visit an emergency department; 
  • have more hospital stays; 
  • are less likely to follow treatment plans; and 
  • have higher mortality rates. 

Additionally, when patients and their families engage in their own care, health outcomes improve, explained Martie Carnie, senior patient advisor at Brigham and Women’s Hospital in Boston. “Once patients fully understand their healthcare situation, then they can partner with their provider in shared decision-making,” said Carnie. 

Putting a literacy initiative into action 

Entities seeking to enhance health literacy initiatives should build from a foundation of using plain language, presented at a 5th or 6th grade reading level. “The audience should understand information the first time they read it,” noted Erin Sturgeon, the patient/family relations specialist at Brigham and Women’s. “The audience must be able to find what they need, understand what they find, and be able to act on that understanding,” she added. 

Related story: How digital health literacy intersects with custom software development

At Brigham and Women’s, all patient-facing documents must be approved by the hospital’s Health Literacy Review Board after cycling through a feedback loop. The process includes document assessment via readability software, communication of assessment results with staff, collaborative actions to improve readability scores, and re-running the document through the readability program. 

When approved, communications can be rolled out in various areas such as wayfinding, pre-op and discharge materials, website content, telehealth communications and instructions, department brochures, and forms used for clinical research trials. In a recent initiative undertaken by the hospital’s anesthesiology team, patients receive text messages conveying information about pain management before and after surgery. 

Supporting health equity by listening to feedback 

Aside from its direct benefits, health literacy should also be viewed as a tool that enhances health equity in communities. Health equity can be “operationalized” by rebalancing systems that have been historically uneven. Information should be assembled with a focus on diversity, equity and inclusion, commented Catina O’Leary, president of Health Literacy Media, which works with health systems and other stakeholders to guide patients to trustworthy sources. 

“The best thing to do is to start patients and community members in the right places,” said O’Leary. “Sometimes people decide to trust what’s easiest, cheapest or most convenient — or what they’ve heard from friends and family. That doesn’t necessarily match the healthiest option for them … We need to help people decipher what is a valid, authentic, authoritative, and appropriate link to get accurate information.” 

O’Leary continued, “None of this happens consistently and well if you don’t partner with communities aligned with specific health conditions. You have to ask people what they are experiencing and what their preferences are, and what have you done well and poorly in communicating information. Our gold standard is testing everything with the key intended audience, and then sticking around for the real questions and criticisms.” 


Frank Irving is a Philadelphia-based content writer and communications consultant specializing in healthcare, technology and sports. 

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