The Importance of Pediatric Health Literacy

Christine Sokoloski, MS
Associate Director of Health Education

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Since most of these health decisions are made by adults, the majority of health literacy studies have focused on adults. From these studies we know that most health care materials are written at a 10th-grade level or higher; yet most adults read at an 8th- or 9th-grade level. In addition, just over 20% of adults read at a 5th-grade level or lower. It's challenging enough to provide health-literate education at an adult reading level, but what do you do when your audience reads at a 5th-grade level?

First, we must establish that addressing the health literacy needs of the pediatric population is important. Yes, parents and caregivers are the ones making health decisions for children, but as children grow they take on more responsibility and make more of their own health-related decisions.  As children hit puberty, they are forced with many health choices. These choices and a child's attitude toward health that develops in childhood can greatly predict that child's adult health behavior. Getting children involved and encouraging more responsibility creates independence and a willingness to improve their health.

Improving health literacy involves creating education around several areas of a child's life. First, health information must be appropriate for parents and caregivers who create the foundation of healthy behaviors in children. Data show that 78 million people (36% of the population) between the ages of 16 and 64 cannot complete "below-basic" health literacy tasks, such as using a dosing chart for an OTC medicine. Information must be presented to adults and caregivers in a health-literate fashion, which includes using plain language, pictures whenever possible, and action-orientated statements. Empowering the adult can empower the child through modeling.

Second, healthcare providers must also be trained on how to properly educate children. They need to understand shared decision making and effective communication skills that are age-appropriate. HCPs can encourage children to ask questions and to "teach back" what they've learned. Encouraging dialog between the child and the healthcare provider establishes the healthcare provider as a partner in health. By establishing this relationship at an early age, it allows for greater opportunity for health issues to be prevented or addressed early on.

And, finally, the school system plays an important role in improving health literacy and health understanding. The American Cancer Society, the American Diabetes Association, and the American Heart Association have stated that school health education programs can improve the well-being and health of the nation's youth. Schools play an important role not only through health-education programs, but by improving literacy levels overall. Some studies have shown that children who have read below their grade level are at greater risk for substance use and sexually transmitted diseases. It should come as no surprise that there's an established connection between limited overall literacy and limited health literacy.

But perhaps the best way to improve health literacy is to get children involved in their health at a young age. Age-appropriate health material can start to establish healthy behaviors. Material should use age-appropriate language, have clear actions with easy-to-follow steps, and find ways to engage the targeted population. For example, a print brochure may be the right way to explain the importance of vaccines to a 30-year-old parent, but to educate an 8-year-old that same information may need to be presented as a game or in an animation.

Improving health literacy in children takes time but is essential to their well-being. Children see and regularly interact with health messages, health interventions, and health practitioners. Providing them with the tools to make empowered decisions will improve health outcomes later in life.