When you have a health decision to make, do you feel fully informed and armed with the knowledge to make a decision? Do you understand what the doctor told you? Interpreting basic health information, especially when it’s a serious issue or you’re feeling pressured for time, can be incredibly difficult and have a direct impact on your health outcome. Having knowledge and understanding of a health issue is part of health literacy. Other factors include education level, language, health behaviors, and the health systems that are accessible.  


What is Health Literacy?

  • Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
  • Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

Health Literacy by the Numbers

Health literacy varies greatly across the U.S. In a study by UnitedHealth Group, even in counties with the highest health literacy, 15-27 percent of the population has limited health literacy. In the counties with the lowest health literacy, 36-59 percent have limited health literacy.

Higher health literacy leads to better health outcomes, since people can make informed, educated decisions. Better health outcomes and informed decision-making lead to lower costs for healthcare organizations over time as people can catch problems early, use preventative care, follow post-care properly, and more.

In fact, according to the UnitedHealth Group study, improving health literacy could save over $25 billion a year and prevent nearly one million hospital visits. For example, Medicare beneficiaries with higher health literacy had:

  • 31% more flu shots
  • 26% fewer avoidable hospitalizations
  • 18% fewer emergency department visits
  • 13% lower healthcare spending per beneficiary
  • 9% fewer hospital readmissions

Healthcare organizations must consider health literacy as health costs rise, demand in healthcare is overloaded, and a labor shortage means limited resources to match the demand.



Language as a Factor in Health Literacy

One of the factors of personal health literacy is language. If someone is limited English proficient (LEP), healthcare organizations need to consider the gap caused by language barriers and lack of language access. While we all might face health literacy issues, the LEP population may be impacted twofold by the same health literacy issues because they have an added struggle of language understanding and access.

For example, a study from BMC Women’s Health found that Spanish-speaking Latinas recovering from breast cancer reported less shared decision-making compared to English-speaking Latina or white patients. In addition, their health-related quality of life and quality of care was worse because of the language barrier.

So what can healthcare organizations do?



Making a Difference for the LEP Population

LEP individuals have historically been marginalized, directly impacting health outcomes and leading to part of the health disparity gap that we now face. Stronger relationships between providers and patients and better communication can improve health outcomes. Here are some things that healthcare providers can do.


Set Up Experienced Interpreters

Have qualified interpreters set up and ready to avoid using ad hoc interpreters. Research has shown that ad hoc interpreters are associated with lower health outcomes and quality of care, as well as higher costs.

  • According to an article on interpreters in healthcare, using professional interpreters for LEP patients is associated with improved clinical care in communication, utilization, clinical outcomes, and satisfaction with care. These four areas reflect disparities in health care.
  • A research study showed that using professional interpreters resulted in a significantly lower likelihood of errors of potential consequence (12%) than ad hoc interpreters (22%) and no interpreters (20%)
  • Using professional healthcare interpreters compared to ad hoc interpreters minimizes negative clinical results, thus reducing long-term hospital costs in the ER and improving LEP patients’ satisfaction. This is based on factors such as length of stay in the ER and hospital overall, medical errors, resource utilized, waiting time, and instructions.

As shown in these articles and studies, set up professional interpreters, so you don’t end up in an ad hoc interpretation or no interpretation situation. Also, include in-person, video, and phone options, as you may have situations that work for each and others that might not be appropriate.


A Success Story: How a Hospital Dropped the Pediatric Mortality Rate in Latinx Children

In one hospital, the mortality rate for Latinx children in the pediatric intensive care unit (PICU) had a 3.7-fold higher mortality risk than White and African American children. The research controlled covariates such as illness severity, age, sex, insurance status, and diagnosis.

The hospital was able to drop the mortality rate to a comparable level through a comprehensive effort of:

  • Cultural sensitivity trainings
  • Hiring more bilingual staff
  • Expanding the use of trained interpreters
  • Translating available materials
  • Expanding outreach to the Latinx communities

Patient Family Educators

A patient family educator (or Community Benefits Manager, Outreach Manager, and other similar titles) is a professional appointed to a patient who helps walk the patient (and family) through treatments, options, etc. in plain language and focuses on that relationship from a relatable educational standpoint. That person advocates for the patient’s needs and helps the patient overcome obstacles. A bilingual patient family educator can help a patient overcome the language barrier by translating medical information into easier-to-understand language, and can share helpful resources (such as Medicare Resource sheets that are already translated into a variety of languages).

Explain Concepts in Plain Language

It can be easy to forget to break down your communication into plain language for general audiences as a medical professional. In addition to trying to understand what’s being said, a patient may be in a state of surprise or confusion, so a patient may not be thinking clearly. Therefore, speaking in plain language is a crucial aspect of communication to consider, especially when speaking to an LEP patient, who has an additional language barrier to overcome. Also, ask about a patient’s understanding, and offer additional ways of reaching out, asking questions, or getting more information through websites, booklets or pamphlets.

Provide Patient-Centered Care

Along with communicating in plain language, look at ways to drive patient satisfaction along each step of the entire patient journey. Ensure patients are nurtured from before the appointment to follow-up services to after-care through translated communications. Provide them with language services in the language they need before any interaction occurs. 

Localize Your Website into Threshold Languages

Having your website in threshold languages is very important for your LEP patients. To better understand your community’s language needs, look at your health data and Google Analytics. Your localized website will open doors for patients.



Improving health literacy leads to better health outcomes and reduced costs for healthcare organizations. To help improve health literacy for the LEP population, health organizations can provide regular interpreters, hire patient family educators, explain concepts in plain language, provide patient-centered care, and localize their website.

We can help you with your language needs, including building a language plan, interpretation, translation, and threshold languages. For example, we have a  secure, on-demand, telehealth interpreting platform for short-term or multifaceted solutions. Contact us at [email protected] or (530) 750-2040 to learn more.