Health Literacy in Orthopaedics

Abstract

Health literacy is a dynamic, multifaceted skill set that relies on patients, healthcare providers, and the healthcare system. In addition, health literacy assessment provides an avenue for evaluating patient understanding and offers insights into their health management capabilities. Inadequate health literacy results in poor patient outcomes and compromised care by considerably hindering successful communication and comprehension of relevant health information between the patient and the provider. In this narrative review, we explore why limited health literacy poses serious implications for orthopaedic patient health and safety, expectations, treatment outcomes, and healthcare costs. Furthermore, we elaborate on the complexity of health literacy, provide an overview of key concepts, and offer recommendations for clinical practice and research investigations. Health literacy has been defined as an individual's ability to obtain, understand, and comprehend information regarding their health, medical conditions, treatments, and long-term care. 1 However, this definition may fall short of encompassing the true complexity of health literacy by focusing primarily on the individual's baseline comprehensive abilities. Although a patient's ability to attain, comprehend, and use new information may be improved by literacy skills such as proficient reading and writing, there is no guarantee that these skills will be applied in a consistent form. This is particularly apparent when a patient finds themselves in an unfamiliar or stressful circumstance that requires specific content knowledge for health decision making. 2 This is also true when delivering orthopaedic care. However, to date, health literacy has received little consideration in orthopaedic literature. 3 Limited health literacy is associated with worse overall physical and mental health, inadequate self-management of chronic disease, higher mortality, higher rates of hospitalization, greater healthcare expenditure, and worse patientreported outcome measure scores. [4][5][6][7][8][9] The 2003 US Department of Education National Assessment of Adult Literacy survey found that 36% of the adult US population (approximately 87 million adults) had basic or below basic health literacy levels. 10 Unlike the intermediate literacy and proficiency literacy levels defined by the survey, basic literacy and below basic literacy levels are considered insufficient for function within the healthcare setting. Inability

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