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Battling the (mis)infodemic: A look at health literacy in Canada

If the COVID-19 pandemic has taught us anything, it’s that we should not underestimate the importance of being able to read, understand, and act on the health information being shared with the Canadian public. With the contrast between the surge of health directives aimed at Canadians and the frequent examples of social behaviour that seem to defy public health orders (Papadakos et al., 2021), one may wonder, how did we get here?

As a health care professional, you are likely familiar with the concept of health literacy: a person’s ability to “access, understand, and utilize information in order to create an informed decision regarding their health” (van Ballegooie & Honag, 2021). In Canada, it’s reported that nine million people have limited literacy skills (Chen et al., 2021), with over half of Canadians reading below a high school level (van Ballegooie & Honag, 2021).

It is important to remember that many factors contribute to a person’s health literacy. Health literacy is not just being able to read and understand written health information. It is affected by a person’s confidence in asking questions, their experience using health resources to stay healthy, and their ability to successfully navigate the health care system. This last point includes a person’s ability to access preventative screening, make decisions about treatments, and self-manage their health at home (Lloyd et al., 2021; Qi et al., 2021; Olisarova et al., 2021).

The global pandemic has brought health literacy to the forefront, highlighting gaps in Canadians’ reading and comprehension levels, as well as in their ability to distinguish between fact and fiction, and in their trust levels in following public health guidance.

Re-examining Canadians’ health literacy matters now more than ever (Abrams et al., 2021; Chowdhury et al., 2021; Papadakos et al., 2021; Qi et al., 2021) as health care professionals continue national efforts to contain the spread of the coronavirus and support thousands of Canadians as they recover from COVID-19 (PHAC, 2021). 

Although addressing the health literacy of Canadians is only one contributor to slowing the spread of the coronavirus, it is a significant one. If Canadians do not have a sufficient understanding of preventative health messaging about COVID-19, the risk of infection and spread of the virus is higher (Abdel-Latif, 2020).

How can health care teams integrate what we know about health literacy into clinical area(s)?

• Engage. In the rush to finalize clinic signage, handouts, or patient pamphlets, don’t forget to include the end user: Nova Scotia Health patients and families. For more on engaging Patient and Family Advisors, check out the Engagement guide: https://library.nshealth.ca/Engagement 
• Review for readability. Nova Scotia Health Library Services’ Patient Education Team is happy to review and make suggestions for any materials (not just pamphlets) that will be used by patients and/or families. Request a plain language review using this form: https://cdha-nshealth-ca.libwizard.com/f/pamphletrequest
• Share credible, easy-to-read, patient-focused resources with your patients and their families:
  • My COVID Recovery NS: Information and resources to help Nova Scotians understand and manage their health after having COVID-19: https://library.nshealth.ca/CovidRecovery
  • Patient Education: A guide to finding easy to understand and trustworthy health information: https://library.nshealth.ca/PatientEducation
• Build your health literacy skillset. Check out these resources for tackling the (mis)infodemic:
  • Abrams, E. M., Singer, A. G., Greenhawt, M., Stukus, D., & Shaker, M. (2021). Ten tips for improving your clinical practice during the COVID-19 pandemic. Current Opinion in Pediatrics, 33(2), 260–267. https://doi.org/10.1097/MOP.0000000000000998
  • Brach, C., Keller, D., Hernandez, L. M., Baur, C., Parker, R., Dreyer, B., Schyve, P., Lemerise, A. J., Schillinger, D. (2012). Ten attributes of health literate health care organizations. NAM Perspectives, 02(6). https://doi.org/10.31478/201206a
  • Kim, Y.-S., Kim, H. A., Kim, M.-S., Kim, H. S., Kwak, M. J., Chun, J., Hwang, J.-I., & Kim, H. (2020). How to improve patient safety literacy? International Journal of Environmental Research and Public Health, 17(19), 7308. https://doi.org/10.3390/ijerph17197308
  • Centers for Disease Control and Prevention - Health Literacy Training (free) https://www.cdc.gov/healthliteracy/gettraining.html

Kallen Rutledge

Librarian Educator, Patient Education Pamphlets Lead
Nova Scotia Hospital, Central Zone