In the United States, nearly 36% of adults have low health literacy – approximately 90 million people[1]. Individuals with low health literacy experience greater health care use and costs compared to those with proficient health literacy. The burden of low health literacy does not only fall on the individual, but it is also up to health care organizations and public health initiatives to reduce the demands placed on individuals in order to improve population health for all.

In August 2020, the definition of health literacy was updated as part of Healthy People 2030, an initiative that sets data-driven national objectives to improve health and well-being over the next decade. According to the Centers for Disease Control and Prevention, Health Literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health and services needed to make appropriate health decisions.
 

Why is Health Literacy Important?

Only 12% of Americans have proficient health literacy[2]. This means that nearly nine out of 10 adults likely lack the skills required to manage their health and prevent disease. Health literacy is essential for a healthy population and critical during times of national emergencies such as the COVID-19 pandemic.

Based on its impacts, including, medical errors, increased rates of illness and disability, loss of wages, and compromised public health, low health literacy is estimated to cost the U.S. economy approximately $236 billion every year[3] ; data that does not include the financial devastation caused by the current pandemic.

Caravan Health, the nation’s leader in accountable care, partners with clients nationwide to improve population health using team-based approaches and value-based care methodologies. Much of Caravan’s emphasis is educating clients and providers everywhere on using value-based care to improve health outcomes, including Social Determinants of Health (SDoH).

The SDoH are economic and social conditions in which people are born, grow live, work, and age. These conditions are shaped by the distribution of wealth, power, and resources at global, national, and local levels. Cara James, Ph.D., director of the Office of Minority Health at the Centers for Medicare & Medicaid Services (CMS), estimates that the SDoH equal 80% of an individual’s ability to access and maintain health. The ZIP code in which an individual resides, access to fresh foods, transportation, and ability to pay for prescription medications are some examples of SDoH and linked to health literacy.

In an on-going, four-part white paper series, Caravan Health plans to dissect the intersections among value-based care, the SDoH, and Health Literacy to address the effects of health disparities.  Caravan Health will highlight the challenges of low health literacy as it relates to the SDoH and provide case study vignettes, potential solutions, and resources.

Topics to be addressed are:

  • The role of screening for social determinants and low health literacy and how to recognize the signs and symptoms
  • The role of cultural competencies of health care professionals and how to improve
  • The importance of trust in the provider-patient relationship and the relationship to improve patient and financial outcomes
  • The high cost of low health literacy
  • Team-based approach to improving health literacy including Caravan methodologies and data points that demonstrate an increase in health literacy rates within Caravan Health ACOs
  • The role of the community health worker as it relates to SDoH


If the U.S. can improve health literacy, health care costs can be reduced and an associated improvement in the quality of and access to health care. Health care professionals must be able to identify and address internal barriers to care delivery which will likely require the restructuring of policies and workflows and the dismantling of silos that prevent open communication among providers, pharmacies, social services, and community health organizations.
 



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MD, MPH, MBA

Dr. Ashok Roy is a practicing board-certified internal medicine physician who joined Caravan Health as the Chief Medical Officer in August 2020.  Dr. Roy comes with over 20 years of experience in population health, healthcare consulting and healthcare administration during his work with healthcare systems, payers, outpatient clinics and governmental/military organizations.  
 



References:

[1] https://www.nationalacademies.org/news/2004/04/90-million-americans-are-burdened-with-inadequate-health-literacy-iom-report-calls-for-national-effort-to-improve-health-literacy

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2668931/

[3] J. Vernon, A. Trujillo, S. Rosenbaum, and B. DeBuono. Low Health Literacy: Implications for National Health Policy. University of Connecticut, 2007.

 

 

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