The findings from the 2018 ABS Health Literacy Survey also showed that for some domains there was variation by age group. Younger people aged 18–24 were almost twice as likely to strongly agree that they have access to social support compared with older people aged 65 and over (39% compared with 20%). In contrast, navigating the health care system appears to be more difficult for younger age groups. Nearly 1 in 5 (19%) people aged 18–24 stated that they find navigating the health care system difficult, and this decreased to 7.9% for those aged 65 and over.
There was also some variation in the results according to main language spoken in the home (Figures 1a and 1b). Overall, the proportion of people who disagreed or strongly disagreed that they feel understood and supported by health care providers was similar for people who spoke English in the home (4.2%) and those who did not (5.2%). However, a higher proportion of people who spoke English in the home strongly agreed they feel understood and supported by health care providers (33%) than those who did not speak English in the home (20%).
Additionally, those who spoke English in the home were more likely to always find it easy to actively engage with health care providers (34%) than those who spoke a language other than English in the home (26%).
How can health literacy be improved?
The National Statement on Health Literacy (ACSQHC 2014b) acknowledges the importance of health literacy in enabling effective partnerships in health, and proposes actions that can be implemented within the health system to improve health literacy levels. This has been a driver for health literacy at the local level, with Local Health Networks, Primary Health Networks and community organisations designing and implementing locally appropriate health literacy interventions.
Some examples of activities being undertaken at the national and community levels to improve health literacy are provided below.
National initiatives
The National Strategic Framework for Chronic Conditions (Australian Health Ministers’ Advisory Council 2017) and the National Safety and Quality Health Service Standards (ACSQHC 2021) are 2 national initiatives that acknowledge and integrate health literacy as an important component of the health system.
Community initiatives
The Centre for Culture, Ethnicity and Health works closely with community, government and health professionals to represent people from culturally diverse backgrounds, particularly migrants and refugees. It provides a range of resources to address health literacy across all audiences, including:
- health literacy training courses – including the first health literacy course in Australia
- health translations directory – an online library of health information translated into more than 100 languages (in conjunction with the Victorian Government)
- Drop the Jargon day – a national day encouraging health professionals to think about using simple language with their clients, in place of medical terms and acronyms.
Where do I go for more information?
For more information on health literacy, see:
References
ABS (Australian Bureau of Statistics) (2019) National Health Survey: health literacy, 2018, ABS, Australian Government, accessed 15 March 2022.
ACSQHC (Australian Commission on Safety and Quality in Health Care) (2014a) Health literacy: taking action to improve safety and quality, ACSQHC, accessed 15 March 2022.
ACSQHC (2014b) National Statement on Health Literacy - Taking action to improve safety and quality, ACSQHC, accessed 15 March 2022.
ACSQHC (2021) National safety and quality health service standards, 2nd edn, ACSQHC, accessed 15 March 2022.
Adams RJ, Appleton SL, Hill CL, Dodd M, Findlay C and Wilson DH (2009) ‘Risks associated with low functional health literacy in an Australian population’, Medical Journal of Australia, 191(10):530–534, doi:10.5694/j.1326-5377.2009.tb03304.x.
Australian Health Ministers’ Advisory Council (2017) National Strategic Framework for Chronic Conditions, Department of Health website, Australian Government, accessed 15 March 2022.
Beauchamp A, Batterham RW, Dodson S, Astbury B, Elsworth GR, McPhee C, Jacobson J, Buchbinder R and Osborne RH (2017) ‘Systematic development and implementation of interventions to OPtimise Health Literacy and Access (Ophelia)’, BMC Public Health,17:230, doi:10.1186/s12889-017-4147-5.
Berkman ND, Sheridan SL, Donahue KE, Halpern DJ and Crotty K (2011) ‘Low health literacy and health outcomes: an updated systematic review’, Annals of Internal Medicine,155(2):97–107, doi:10.7326/0003-4819-155-2-201107190-00005.
Bo A, Friis K, Osborne RH and Maindal HT (2014) ‘National indicators of health literacy: ability to understand health information and to engage actively with healthcare providers – a population-based survey among Danish adults’, BMC Public Health, 14:1095, doi:10.1186/1471-2458-14-1095.
De Oliveira GS, Errea M, Bialek J, Kendall MC and McCarthy RJ (2018) ‘The impact of health literacy on shared decision making before elective surgery: a propensity matched case control analysis’, BMC Health Services Research,18:958, doi:10.1186/s12913-018-3755-9.
Geboers B, de Winter AF, Spoorenberg SLW, Wynia K and Reijneveld SA (2016) ‘The association between health literacy and self-management abilities in adults aged 75 and older, and its moderators’, Quality of Life Research, 25(11):2869–2877, doi:10.1007/s11136-016-1298-2.
Heijmans M, Waverijn G, Rademakers J, van der Vaart R and Rijken M (2015) ‘Functional, communicative and critical health literacy of chronic disease patients and their importance for self-management’, Patient Education and Counseling 98(1):41–48, doi:10.1016/j.pec.2014.10.006.
Kickbusch I, Wait S and Maag D (2006) Navigating health: the role of health literacy, Alliance for Health and the Future, International Longevity Centre UK (United Kingdom), accessed 14 April 2022.
Kobayashi LC, Wardle J and von Wagner C (2014) ‘Limited health literacy is a barrier to colorectal cancer screening in England: evidence from the English Longitudinal Study of Ageing’, Preventive Medicine, 61:100–105, doi:10.1016/j.ypmed.2013.11.012.
Marvanova M, Roumie CL, Eden SK, Cawthon C, Schnipper JL and Kripalani S (2011) 'Health literacy and medication understanding among hopsitalized adults', Journal of Hospital Medicine, 6(9):488–493, doi:10.1002/jhm.925.
Miller TA (2016) ‘Health literacy and adherence to medical treatment in chronic and acute illness: a meta-analysis’, Patient Education and Counseling, 99(7):1079–1086, doi:10.1016/j.pec.2016.01.020.
Mitchell SE, Sadikova E, Jack BW and Paasche-Orlow MK (2012) ‘Health literacy and 30-day postdischarge hospital utilization’, Journal of Health Communication, 17(Supplement 3):S325–338, doi:10.1080/10810730.2012.715233.
Moreira L (2018) Health literacy for people-centred care. Where do OECD countries stand?, OECD Health Working Papers no. 107, OECD, accessed 14 April 2022.
NZ (New Zealand) Ministry of Health (2018) Questionnaires and Content Guide 2017/18: New Zealand Health Survey, NZ Ministry of Health, NZ Government, accessed 14 April 2022.
Osborne RH, Batterham RW, Elsworth GR, Hawkins M and Buchbinder R (2013) ‘The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ)’, BMC Public Health, 13:658, doi:10.1186/1471-2458-13-658.
Poureslami I, Nimmon L, Rootman I and Fitzgerald MJ (2017) Priorities for action: recommendations from an international roundtable on health literacy and chronic disease management, Health Promotion International, 32:743–754.
Rowlands G, Protheroe J, Winkley J, Richardson M, Seed PT and Rudd R (2015) 'A mismatch between population health literacy and the complexity of health information: an observational study', British Journal of General Practice, 65:e379–e386, doi:0.3399/bjgp15X685285.
Seo J, Goodman MS, Politi M, Blanchard M and Kaphingst KA (2016) ‘Effect of health literacy on decision-making preferences among medically underserved patients’, Medical Decision Making, 36(4):550–556, doi: 10.1177/0272989X16632197.
Sørensen K, van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H and (HLS-EU) Consortium Health Literacy Project European (2012) ‘Health literacy and public health: a systematic review and integration of definitions and models’, BMC Public Health, 12:80, doi:10.1186/1471-2458-12-80.