23.10.2018 Communication is an important tool for improving health literacy
The FOPH has set itself the goal of improving health literacy and self-management of chronic disease among the general public. Communication can, at various levels, help achieve this goal.
Many people in Switzerland have difficulty accessing, understanding and applying health-related information. This is the conclusion drawn in a study of health literacy in the Swiss population conducted in 2015. Health literacy was found to be problematic or even insufficient, particularly among lower income groups and migrants. Good communication is an important constituent of efforts to improve health literacy. In particular, it includes
• raising public awareness in order to prevent diseases or addiction
• providing easily accessible and understandable health information, and
• promoting understanding between health professionals and patients.
The FOPH has set itself the goal of improving health literacy in the general public. The Swiss government’s Health 2020 Strategy and its NCD Strategy 2017–2024 provide the basis for these efforts. To achieve its goal, the FOPH is deploying a range of communication measures such as public awareness campaigns (on HIV, organ donation, etc.). Rather than relying on one-sided transmission of information, it is focusing increasingly on dialogue, for instance using social media or apps that enable feedback and exchanges to take place.
Also on offer is the “migesplus” online platform, which is the portal for equitable health access run by the Swiss Red Cross and supported by the FOPH. This platform disseminates easily understandable health information in a number of different languages. It makes brochures, flyers and films available which originate from 80 different health organisations and are designed specifically for people with poor health literacy. Particularly in demand is the “Health Guide to Switzerland” brochure, which explains our healthcare system in an easy-to-understand way and is available free of charge in 18 different languages.
The current organ-donation campaign is another FOPH measure that demonstrates how important communication can be: any decision for or against donation of an organ needs to be made at an early enough stage because in an emergency the time or opportunity to think about it is often lacking. If this decision has to be made under emergency conditions, experience shows that uncertainty about what the patient really wants tends to nudge family members towards deciding against organ donation. Accordingly, the organ-donation campaign aims to persuade as many people as possible to make their wishes known to relatives in advance.
A further important area is communication between health professionals and patients (see interview with Sabina Hunziker).Health professionals need to be able to express themselves clearly and understandably – and also to create an atmosphere of trust around any discussion with patients.
But what is health literacy?
But what does the term “health literacy” actually mean? It denotes people’s knowledge, motivation and skills with regard to accessing, understanding, appraising and applying health information. A health-literate individual is someone who is able to make decisions in day-to-day life that have a positive effect on its health. This includes taking a critical approach to information: do I need to obtain a second opinion from a doctor? Do I really need this vaccination? Health literacy encompasses issues of disease prevention and health promotion as well as the ability to manage illness. For patients, health literacy is a key factor in ensuring that treatment is successful and in improving patient safety. Studies show that individuals with a higher level of health literacy are associated with a lower number of hospital stays – for instance because they administer medicines correctly. Health-literate individuals are able to cope more effectively with their illness and the changes in their personal circumstances. Moreover, health literacyprovides an important foundation for cooperative care between healthprofessionals and patients, and facilitates active, self-determined participation in the healthcare system in the first place. This approach to illness and health care is an element of health literacy and is referred to as “self-management”.
Communication is a key factor
In Switzerland, there is considerable scope for improvement in the field of health literacy. Efforts to improve it among the general public will assign a key role to communication. There is a need for more awareness-raising activities aimed specifically at people with a low level of health literacy. Numerous options are available, for instance creating easy-to-understand texts and graphics or producing explanatory films on specific diseases. Health professionals can, for their part, apply techniques such as the“show-me-method” to ensure that patients have really understood what has been explained to them. Private-sector health associations (“health leagues”) can also play an important role by developing and deploying easy-to-understand information material.
However, changes to the health system itself would also be worth considering. This is a relatively complex area at present, which means that a lot of responsibility remains with the individual. People with a low level of health literacy may feel overwhelmed by this complexity. Targeted communications at various levels plus clear and simple structures can help the population to find their way through the health system and make the decisions that are right for them.
Karin Gasser, Equal Opportunities Section,