By: Alex Meng
In 2024, an urgent yet often overlooked crisis has surfaced: critically low health literacy, which continues to drive the spread of preventable diseases and exacerbate the impact of widespread misinformation. Despite remarkable technological advances, health literacy remains critically low in many communities worldwide, with vulnerable populations—such as immigrants, low-income groups, the elderly, and racial minorities—bearing the brunt of the consequences. In the U.S. alone, around 80 million people struggle with low health literacy, with many concentrated in rural and elderly communities, and this trend is mirrored globally.
Figure 1: Health Literacy Across the US by County
Source: County Health Literacy Level, UnitedHealth Group, 2020
For these groups, understanding basic health information is not just a matter of convenience; it is a matter of life and death. Systemic barriers—from rigid socioeconomic structures to polarizing rhetoric such as anti-vaccine misinformation and the vilification of immigrants—continue to perpetuate low health literacy, blocking access to essential resources, fostering mistrust in healthcare, and deepening health inequities. Addressing these challenges requires coordinated action from policymakers, healthcare providers, and communities alike, underscoring the urgency of making health literacy a public health priority.
In order to tackle health literacy, one must first understand what is health literacy and how it plays a role in lessening the global health crisis. Health literacy, defined as the ability to obtain, comprehend and apply health information to make informed decisions related to health, has been demonstrated to help improve health status. The rise of technology has led to the emergence of digital health literacy, meaning the ability to find, evaluate, and communicate health information through digital tools, making it crucial for individuals to develop the skills to navigate these platforms and engage with healthcare systems effectively.
Figure 2: Integrated conceptual model of health literacy
The model combines the main elements of health literacy (oval shapes in the center) with factors that impact it and pathways linking it to health outcomes.
Every human will experience illness, and it is our natural right to receive the care we need, but without the necessary knowledge of our health or access to proper guidance, the consequences of low health literacy could mean missing critical opportunities for treatment, potentially turning treatable conditions into untreatable ones—this should never happen. To prevent this, improving health literacy is not just a matter of individual empowerment, but a societal responsibility to ensure everyone has the tools to make informed health decisions and receive timely care. Therefore, an increased rate of health literacy is essential when it comes to lessening the effects of the global health crisis.
Utilizing Technology
Utilizing technology through organized communication channels, online resources, and digital health records, such as patient portals, can significantly enhance health literacy by bridging the gap between healthcare providers and patients, combining human expertise with technological tools for more efficient and accessible care. Studies have consistently shown that digital health literacy plays a vital role in promoting better health outcomes, and that limited health and digital literacy have been linked to poor health outcomes, increased healthcare costs and health disparities. To adequately address this, there has been growing recognition of digital communication tools such as health apps and online health records in improving health literacy and empowering individuals to take a more active role in managing their health.
Figure 3: Worldwide Searches for Health and Hygiene Terms on Google Over the Past 5 Years
*Numbers represent search interest relative to the highest point on the chart for the given region and time. A value of 100 is the peak popularity for the term. A value of 50 means that the term is half as popular. A score of 0 means that there was not enough data for this term.
Source: Google Trends. 2021. https: //trends.google.com/trends/.
However, despite the practicality of these online platforms to reach a broader group of audience, there holds a fundamental challenge, as accessing these digital communication tools and having reliable internet connectivity to do so remain a significant barrier for certain populations, leading to disparities in digital health literacy. This limited access to technology, known as a phenomenon called digital divide, disproportionately affects underserved communities, older adults, and individuals with lower socioeconomic status. Consequently, these populations face significant challenges in obtaining and utilizing health information, which limits their ability to make informed decisions about their health. The digital divide not only restricts access to essential resources such as telemedicine and online health education, but it also deepens existing health disparities, as those without reliable technology are excluded from opportunities to improve their health literacy and engage effectively with healthcare systems. Addressing this divide is crucial to ensuring equitable access to healthcare information and improving overall health outcomes for vulnerable groups.
Figure 4: Health Literacy of Adults, By Age
Language Barrier
A significant barrier to improving health literacy among immigrant populations is the language divide between patients and healthcare providers, which often leads to misunderstandings, misdiagnoses, and inadequate care, ultimately hindering immigrants’ ability to make informed health decisions. Many immigrants, particularly those who are non-English speakers, face difficulties in understanding medical terminology, instructions, and treatment options. This not only reduces both parties’ satisfaction and leads to confusion, it also affects immigrants’ ability to navigate complex healthcare systems, understand their rights, and make informed decisions about their health. Numerous studies have shown that migrants generally score lower on health literacy measures and that migrants have poorer access to and use less information and health promotion, disease prevention and care services.
Additionally, interventions aimed at increasing access to cancer screening, mental health services, diabetes education, smoking cessation, HIV programs and child immunization have seen less success when it is introduced to migrant populations, as the language barrier prevents effective communication and engagement with these critical health services. Without proper understanding, immigrants may delay seeking care, misinterpret health advice, or fail to follow treatment plans, leading to worsened health outcomes. Furthermore, the lack of culturally competent communication from healthcare providers exacerbates the problem, as many providers are not trained to address the unique needs of immigrant populations.
Figure 5: Quote on the Lack of Focus on Immigrant’s Health
Although there are few programs directly addressing the significant barriers to health literacy among immigrant populations, one notable example is the work of Becca Freed and Health Research for Action (HRA). In an interview with Director Freed, she stated that HRA has been collaborating with the California Department of Public Health Office of Oral Health to improve health literacy among diverse populations. Over four years, the initiative has examined the knowledge of oral health practitioners regarding health literacy and identified gaps in formal education and resources within dental practices. To bridge these gaps, HRA developed customized educational materials and provided extensive training, particularly through a partnership with UCSF, aimed at enhancing practitioners’ communication skills with patients. This project also focuses on translating materials into multiple languages to ensure accessibility for immigrant populations, further highlighting the importance of culturally and linguistically tailored approaches to overcoming barriers in health literacy.
Figure 6: HRA helps promote health literacy at insurance open enrollment event
Source: Health Research for Action UC Berkeley Website
Politicization of Public Health
The weaponization of public health has become a significant obstacle in efforts to increase health literacy, ultimately fueling the global health crisis. As health measures are politicized and used to advance specific agendas, public trust in health information erodes, making it difficult for individuals to discern credible guidance from misinformation. When health advice is manipulated or framed divisively, people may become skeptical or even resistant to essential health practices like vaccination, hygiene protocols, and preventive screenings.
Figure 7: Republicans Increasingly Make Up A Larger Share Of Those Who Remain Unvaccinated Against COVID-19
NOTE: Party identification includes independents who lean towards either party. The difference between percent unvaccinated in Sept. (25%) and Oct. (27%) is within the margin of error. See topline for full question wording.
Source: KFF COVID-19 Vaccine Monitor, 2021
With 68% of American adults reporting social media as their source of news, platforms such as Twitter have become important communication channels for US politicians to share their agendas, many of which relate to public health especially after COVID-19. While some politicians use these platforms to promote accurate health information and encourage preventive practices, others have leveraged social media to spread misinformation, downplay the severity of public health issues, or dismiss scientific recommendations. Inflammatory statements such as accusations of pharmaceutical companies, governmental agencies, or scientists of corruption, amplifies mistrust between public health officials and the public, making it harder for individuals to make informed health decisions. Ultimately, inflammatory language shifts the focus away from rational discussions and reinforces doubts about vaccine safety and efficacy, decreasing the health literacy of our society as a whole.
Figure 8: Congresswoman Marjorie Taylor Greene (R-Ga.) Take on Vaccine
Legislations and Government Plans
While it is true that digital health literacy, language barriers, and inflammatory language present significant obstacles to improving health literacy, some argue that recent legislation and government initiatives have made strides in addressing these issues. Legislations that promote health literacy are crucial because they can significantly improve public health by enabling individuals to understand and utilize health information effectively, leading to better health outcomes, reduced healthcare costs, and a more equitable distribution of care, especially for marginalized populations who often face greater barriers to accessing clear health information.
Healthcare regulations address issues of accessibility and affordability, aiming to ensure healthcare services are available to all individuals, regardless of their socioeconomic status or insurance coverage. By having more legislation aimed at increasing health literacy, society is able to:
- Safeguard the rights and interests of individual
- Improve access to accurate and actionable health information and usable health services
- Prevent health problems
- Better management of health
List of legislations specifically aiming to increase health literacy:
- The Affordable Care Act of 2010:
- Defines health literacy as the ability to understand and use health information and services to make health decisions
- The Plain Writing Act of 2010:
- Requires federal agencies to use plain language when communicating with the public
- The 21st Century Cures Act:
- Directs the Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention, and the U.S. Department of Health and Human Services to improve health literacy
- The National Action Plan to Improve Health Literacy: A multi-sector plan that aims to improve health literacy by:
- Making health information available to everyone
- Making health services easy to understand
- Engaging organizations, professionals, policymakers, communities, individuals, and families
- The Oral Health Literacy and Awareness Act of 2021
- The Oral Health Literacy and Awareness Act of 2023
While legislation plays a vital role in promoting health literacy and access to healthcare, the reality of expensive insurance remains a major barrier, limiting many individuals’ ability to fully benefit from these initiatives. Despite laws aimed at increasing access, high insurance costs can prevent individuals, particularly those from low-income backgrounds, from receiving necessary care and information in a timely manner. Recognizing the burden of high insurance costs, there has been more legislation introduced to combat these financial barriers and expand access to healthcare.
The following are legislations specifically aimed towards making insurance more affordable:
- Affordable Care Act
- Reduce insurance costs by providing subsidies to low- and middle-income individuals, expanding Medicaid coverage, and implementing cost-control measures for insurance premiums.
- Health Insurance Portability and Accountability Act (HIPAA)
- Prohibits group health plans from denying coverage due to pre-existing conditions or other health factors, making it easier for individuals with prior health issues to access insurance.
- Health Information Technology for Economic and Clinical Health Act (HITECH)
- Promotes the adoption of electronic health records (EHRs) and modernizes health information technology systems.
- Reduce administrative costs and improve efficiency in healthcare delivery, potentially leading to lower costs for patients.
- Emergency Medical Treatment and Labor Act (EMTALA)
- Requires hospitals that receive Medicare funding to provide emergency medical treatment to any individual, regardless of their insurance status or ability to pay.
Figure 9: Former President Obama Signing the Affordable Care Act Into Law on March 23, 2010
Source: USA Today, Win McNamee, Getty Images
Solutions
Addressing the root causes of low health literacy and implementing comprehensive solutions requires a multifaceted approach that prioritizes accessibility, education, and community engagement. Here are a few things to address:
- Digital Inclusion
- Ensure equitable access to technology and digital health tools.
- Governments and private organizations can:
- Invest in infrastructure for underserved areas (e.g., broadband expansion, affordable devices).
- Implement targeted digital literacy programs for:
- Older adults
- Low-income families
- Non-native speakers
- Language Barriers
- Expand availability of multilingual health materials.
- Train healthcare providers in culturally competent communication.
- Highlight examples such as:
- Programs by Becca Freed
- Initiatives from Health Research for Action
- Combating Politicization of Public Health
- Prioritize transparent communication and public trust-building measures.
- Focus on evidence-based messaging and counter misinformation with accessible, relatable content.
- Encourage social media platforms to:
- Moderate harmful misinformation
- Promote credible health resources
- Engage community leaders and influencers to amplify accurate health messages and foster trust.
In conclusion, health literacy is more than just the ability to understand health-related information; it is a critical determinant of individual and community well-being. It empowers people to make informed decisions about their health, navigate complex healthcare systems, and engage in preventive care, ultimately reducing health disparities and improving overall public health outcomes. By fostering collaborations among policymakers, healthcare providers, educators, and communities, and by leveraging technology and culturally competent strategies, we can create an inclusive healthcare system where everyone has the knowledge and resources to lead healthier lives. Health literacy is not just a public health goal—it is a fundamental human right that must be prioritized in the fight against global health inequities.
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