Health literacy is defined by the WHO as the cognitive and social skills determining the ability of all individuals to understand and use any information and health education material necessary to maintain a healthy life (World Health Organization, 2016). It is important that a basic level of health literacy is provided to people in all walks of life, as good health is a common necessity to all. The level of health literacy ranges from reading the dosage of a prescribed drug, to identifying any symptoms in their own body. Health literacy, akin to technology and political literacy, is an evolving knowledge, but unlike the other streams, it is a mandatory need for every person. It can be said that health literacy has increased with the advent of the internet, which provides a great content base to all with easy accessibility (Nutbeam, 2000). However, there are still a lot of people with limited health literacy, and it is these people who have to be targeted, to impart health education.

Cultural diversity is the norm that is seen in the world, with a variety of knowledge systems, beliefs, ethics and customs. Even though globalization has brought about a cultural unification, numerous cultures are still intact in their practices. Health beliefs and practices too differ within different cultures. However, it is important the health literacy is imparted to all people irrespective of their cultural backgrounds. It is indeed challenging to break the barriers of cultural diversities to work on bring about health literacy (Paasche‐Orlow, Parker, Gazmararian, Nielsen‐Bohlman, & Rudd, 2005). This paper discusses the crucial importance of health literacy in effective communication in a culturally diverse healthcare environment, the relationship between them, and the strategies employed to enhance health literacy and communication.

Factors Influencing Health Literacy

  • Literacy level of the individuals – This includes the reading, writing, and numeracy skills of the people. It is important as the basic level of literacy defines the ability of the person to process information pertaining to health education.
  • Current health status – The individual’s current health status plays a vital role in the level of health literacy of a society. For example, if the individual is already in a physically or mentally poor state of health, he would not be in a position to appreciate the information which the healthcare provider gives. In a broader perspective, a society that is suffering from an epidemic needs immediate medical care, with health education coming after not before the care.
  • Language and communication barriers – More that what is said, knowing what is understood is important. Health literacy delves on the principles of effective communication, and a miscommunication could defeat the purpose of health education.
  • Cultural barriers – Every culture has its own set of rules and practices, which includes varying health practices. Health literacy might reveal some ideas and issues that might be a taboo for some, and contradictory to some communities. It is important to be sensitive to the various practices of different cultures, in order to provide effective health education.
  • Decision making – Many people are not the decision makers with regard to their own health; they might have to rely on their benefactors in order to access healthcare facilities (Jorm, 2000). This leads to improper access and utilization of healthcare, especially if the benefactor is not health literate. It is the duty of the healthcare educator to provide adequate education and reason out with the people on the need for proper health literacy

Effective Communication in Health Literacy

Communication is one of the main parameters that can make or break any relationship. In the relationship between the healthcare provider and recipient, it is necessary to have effective communication skills in order to drive the point through, and to dispel any misunderstandings (Nielsen-Bohlman, Panzer, & Kindig, 2004). A few criteria for effective communication skills to be used while embarking on a health literacy programme are:

  • Usage of plain and simple language – Plain language makes the information easy for the people who are not associated with the healthcare field to understand and implement. It involves clear and effective communication, straight forward phrases, avoidance of technical terms, medical jargons, and the use of foreign language that is very common in the medical terminologies. The plain language communication would be very helpful for others to understand and even pass on the information to many others, so that the education does not stop with them.
  • Open Attitude – A health educator with the aim of providing healthcare literacy to the general public of a particular community must first gain the trust of the people. In order to achieve that, the educator must be an ardent listener, and a keen observer, so that he/she can grasp the real issue of the people, understanding what they know and what they do not, and provide the needed health education (Chew, Bradley, & Boyko, 2004).
  • Understanding body language and non-verbal cues – One of the most important strategies in being a health educator is identifying non verbal communications and cues of the people who are the recipients of the education. This might come handy when the audience is not in sync with the educator, or when there is a language barrier and the translator does not perform efficiently (Williams, Davis, Parker, & Weiss, 2002). For example, if there is a general wave of misunderstanding of the educator by the people, the educator must easily be able to catch the cues and clear the doubts quickly.

Steps to ensure effective communication in health literacy must be taken in order to drive home the point, and to achieve the basic purpose of health education.

Strategies to Enhance Health Literacy

Health literacy is highly essential in every stage of life, in order to lead a healthy life. Upon analyzing the factors that influence health literacy, the numerous barriers to its achievement can be seen. However, in order to break the barriers and implement effective health literacy many strategies are implemented to improve the current state of health literacy.

  • Incorporating health education in the curriculum – Health Education is essential right from childhood, when the child is able to independently manage schooling on his own. It is essential that health education is a part of the school and college curriculum, in order to inculcate a healthy living right from school days (Kickbusch, 2001). This would help identify and prevent the occurrence of many health issues that occur mainly due to insufficient knowledge on the issue.
  • Making healthy living a part of life – Instead of health education being seen as a separate entity, it must be integrated with one’s day to day living. Healthy habits such as consuming a proper balanced diet, knowing which foodstuffs to eat in moderation and which to avoid, the right kind of exercise to each person, etc must be coordinated with one’s day to day living. This would help prevent a great amount of diseases that stem from poor lifestyle habits (Schillinger, et al., 2002).
  • Operating at the potential intervention points – The potential intervention points of the healthcare delivery model constitute the culture, health and the education system of the locality. The first point of contact would be the family, where the person’s beliefs and customs are formed; here is where health education has to be imparted first. Next is the healthcare system, where vaccinations and the basic managements are taken care of. Here is where health education must be incorporated along with the treatments given. The education system is the next factor, where, as discussed before, the health literacy must be a part of an individual’s schooling (Paasche-Orlow & Wolf, 2007).
  • Encouraging the use of technology in achieving health literacy – With the advent of technology, man’s life has become far simpler. In healthcare, technology has become a boon to the field, with the knowledge about the latest technology available with the touch of the finger (Norman & Skinner, 2006). Healthcare professionals and educators must encourage the people to use the technology to obtain health education, and to use the content available discreetly. However, the people must be advised not to completely rely on any information obtained without confirming with the physician.


Health literacy and health education are long standing processes that have to be inculcated at the grass root levels of the society. Implementing health literacy is not an easy task, given the existing and potential barriers there are to it. However, identifying the influencing factors and obstacles involved in the process, and the effective application of the suitable strategies, can be used to promote health literacy. It is the combined effort of all the stakeholders of health – the providers, the recipients and the mediators, in creating a completely health literate and eventually a healthy society.


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