Health Literacy and Its Role in Financial Literacy

This video provides an in-depth exploration of health literacy, which the speaker, Dr. Eric Bricker, reframes as "patient skill." He argues that just as individuals possess various life skills like budgeting or navigating public transportation, being a patient also requires a distinct set of skills to effectively engage with the healthcare system. The official definition of health literacy, as cited from government sources, is the capacity to obtain, process, and understand health information to make appropriate health decisions. Dr. Bricker emphasizes that patients exhibit varying levels of this skill, impacting their ability to make effective choices for their own health.

The presentation details several factors associated with low health literacy, identifying it as a national problem in America. These factors include poverty, lack of a high school degree, having Medicare or Medicaid insurance (versus private commercial insurance), being male, being over 65 years old, and English as a second language. The video then outlines the significant negative consequences of low health literacy, supported by findings from a meta-analysis of 81 studies. These consequences include higher rates of hospitalization and emergency room utilization, lower rates of preventative screenings like mammograms, decreased flu shot rates, and critically, lower medication adherence.

Dr. Bricker then shifts to discussing interventions to improve health literacy, categorizing them into three levels: clinician-patient, system-patient, and community-patient interactions. For clinician-patient interactions, he advises healthcare professionals to avoid jargon, explain medical terms clearly, and speak more slowly to allow patients to absorb information. At the system and community levels, effective education needs to be clear, utilize visual aids (especially human faces, as brains are hardwired to respond to them), and be delivered in a shame-free, non-judgmental manner, akin to coaching to improve a skill. He extends this concept to "financial health literacy," highlighting the need for patients to understand complex financial aspects of healthcare such as deductibles, coinsurance, Explanation of Benefits (EOBs), and prior authorizations. He cites the Allen Health Academy's 16-video curriculum as an example of effective financial health literacy education that employers can integrate into wellness programs, concluding with a math analogy to illustrate that providing data (like biometrics or EOBs) without teaching the "equation" (literacy) to interpret it renders the data useless for decision-making.

Key Takeaways:

• Health Literacy as "Patient Skill": Health literacy is not merely an academic concept but a practical "patient skill" that varies among individuals and significantly impacts their ability to make informed health decisions. This reframing helps to de-stigmatize the issue and focus on skill improvement.
• Socioeconomic and Demographic Determinants: Low health literacy is strongly correlated with factors such as poverty, lower educational attainment, specific insurance types (Medicare/Medicaid), older age, being male, and English as a second language, highlighting systemic challenges.
• Significant Negative Health Outcomes: A meta-analysis of 81 studies confirms that low health literacy leads to tangible adverse outcomes, including increased hospitalizations, higher ER visits, reduced preventative screenings (e.g., mammograms), lower vaccination rates (e.g., flu shots), and decreased medication adherence.
• Multi-Level Intervention Strategies: Improving health literacy requires a multi-pronged approach involving interventions at the clinician-patient level (e.g., clear communication, slower speech, no jargon), system level (e.g., hospital systems, insurance, employers), and community level.
• Principles of Effective Health Education: Education designed to improve health literacy should be clear, utilize engaging visual aids (especially human faces to leverage natural brain responses), and be delivered in a shame-free, non-judgmental coaching style to foster skill development rather than imply deficiency.
• Superiority of Video for Education: Video is presented as a highly effective medium for delivering health information due to its visual and auditory nature, making it more engaging and easier to absorb than written materials, especially in the context of modern smartphone and internet access.
• Criticality of Financial Health Literacy: Beyond clinical information, understanding the financial aspects of healthcare (deductibles, co-insurance, EOBs, prior authorizations) is a crucial component of overall health literacy, enabling patients to navigate costs and make sound financial decisions related to their care.
• Actionable Data Requires Literacy: Providing individuals with health-related data (e.g., biometrics, EOBs) without also equipping them with the "equation" or literacy to understand and act upon that data is ineffective, akin to giving someone an algebraic equation without teaching them how to solve it.
• Corporate Wellness Program Integration: Employers should consider integrating financial health literacy education into corporate wellness programs, as current assumptions that employees understand complex healthcare financial data are often incorrect.
• The Allen Health Academy Model: The Allen Health Academy's 16-video curriculum on financial health literacy is highlighted as a practical example of a system-level educational resource that employers can leverage to improve their health plan members' understanding.
• Medication Adherence Impact: The direct link between low health literacy and lower medication adherence is a critical insight for pharmaceutical companies, suggesting that improving patient understanding can lead to better treatment outcomes and commercial success.

Tools/Resources Mentioned:

• Allen Health Academy: A 16-video curriculum focused on financial health literacy, recommended for employers to use with health plan members.
• Video as an Educational Medium: Emphasized as a highly effective way to provide clear, engaging information compared to written materials.

Key Concepts:

• Health Literacy: The capacity to obtain, process, and understand health information to make appropriate health decisions.
• Patient Skill: An alternative, less "wonky" term for health literacy, emphasizing that it is a learnable ability.
• Financial Health Literacy: The specific skill set required to understand and navigate the financial aspects of healthcare, including insurance terms, bills, and costs.
• Clinician-Patient Interaction: The direct communication between healthcare providers and patients.
• System-Patient Interaction: How healthcare systems (hospitals, insurers, employers) communicate with and educate patients.
• Community-Patient Interaction: Broader educational efforts within communities to improve health understanding.

Examples/Case Studies:

• Marshall Allen: A former ProPublica healthcare journalist and professor who founded the Allen Health Academy.
• Compass: A company that helped over 1.8 million people navigate health insurance and healthcare over 11 years, encountering many with low financial health literacy.
• Math Analogy (y=mx+b): Used to illustrate that providing data (m and b) without teaching the method to interpret it (how to draw the line) makes the data useless.