Health policy for NPs: health literacy, cultural competence, and communication

Almost half of the American adults have a health literacy problem and 40 million cannot read complex literature (IOM, 2004). Those with low health literacy are often people already at a disadvantage in the US healthcare system—the elderly, the poor, the poorly educated, and racial minorities. If the patient does not understand how to manage their chronic disease, they visit the emergency department more, experience more hospitalizations, and more morbidity. This is significant for policymakers and for Advanced Practice Registered Nurses (APRNs). For nearly twodecades policymakers have been working to bring the problem of health literacy to the attention of health professionals, but more needs to be done. To be more effective at the point of care, APRNs need to expand their cultural competence and use evidence-based health literacy tools such as “reach back” to assess health literacy. These actions have both been shown to improve communication and overall health outcomes (AHRQ, 2020). This chapter will provide an overview of health literacy, explore effective communication strategies, describe the relationship between health literacy and cultural competence, and examine national policies designed to improve health literacy in the United States.