Health literacy is the foundation for living a healthy life. Communities are less capable of functioning economically when in an unhealthy state.

“Health literacy is the knowledge, motivation, and skills needed to make decisions about healthcare, disease prevention, and health promotion,” said Megan Kelley, assistant professor in the Department of Nutrition and Health Sciences at the University of Nebraska–Lincoln.

Kelley’s focus on health education and health literacy explores how access to information impacts individual decision-making and how community-based health affects quality of life.

Access influences an individual’s decision-making, which ultimately affects community wellbeing. Kelley said community members are more likely to have better health outcomes when local leaders create community-based strategies to promote health.

Health Literacy in Nebraska

An individual’s health literacy depends on the ability to find, understand, and apply information, which determines wellbeing for the individual and the community, according to Kelley. 

“When people are self-directed, equipped members of society, they can find information they need to be healthy,” Kelley said.  

During summer 2019, Kelley included questions in the Nebraska Annual Social Indicators Survey to determine what factors influencing health literacy in Nebraska. The questions included different forms of health literacy, such as functional literacy (for example, the ability to read and understand medical forms) and communicative literacy (for example, the likelihood of asking questions of health providers if more information is needed).

According to the findings, in rural Nebraska, 69.8% of respondents reported excellent functional literacy compared to 73.6% of respondents in urban Nebraska, meaning that many Nebraskans feel confident in the ability to read and understand medical forms. 

Communicative literacy was reported to be lower in rural Nebraska with 37.1% reporting excellent communicative literacy, compared to 47.8% in urban Nebraska. These findings indicate that many Nebraskans may not be comfortable with or may face barriers to asking questions of their healthcare provider.

Health literacy empowerment also measured whether people took action to address a health issue in their community within the last year. In rural Nebraska, 14.4% reported that they took action to address a community health issue, while 20.4% took action in urban Nebraska.

“These findings suggest that rural Nebraskans may tend to defer to the authority of their care providers or that they may be more satisfied with their quality of life, but there is more to learn based on initial results,” Kelley said.

Improved health literacy in Nebraska means an improved understanding of, and ability to act on, important health concepts. Having a solid foundation of how to access information ultimately influences health behavior, Kelley said.

“More accurate and accessible health knowledge ultimately leads to better informed health behaviors,” Kelley said.

Community Input Builds Community Health Programs

Community-based health programs function in a ground-up approach where community members have a say in how health programs are designed within their community or how health resources are distributed, Kelley said. 

For example, community-based nutrition and exercise programs not only provide opportunities for fun and engaging connection among community members, but also provide opportunities for local organizations to support and enhance health by offering time-space products or services.

Kelley said that any community-based health program in Nebraska should start with a clear definition of who they want to serve and then spend time learning about the needs, priorities, and resources available to people.

“The goal of health literacy is for individual knowledge and skills to match environmental demands,” Kelley said. “Creating a health literate environment is kind of a balancing act that takes into consideration the needs and capabilities of community members and taking steps to either improve those capabilities to match the environment, or to improve the environment to match those capabilities.”

Understanding environmental demands begins with a thorough understanding of the community to create a development plan that is more accessible, especially when working with a diverse community, Kelley said.

Healthier Communities Are a Team Effort

In a health literate community, people can make accurate judgements based on risk and benefits and use judgments to take action for greater wellbeing, Kelley said. Community-based health is built upon an understanding of the real and perceived needs, resources, and priorities of people in community settings.

“The more communities think intentionally about cultivating an environment that encourages people to share their wants and make their needs known, the better they can promote health,” Kelley said.

Components of community-based health include both physical and social aspects. The physical aspect focuses on access to resources, such as healthy foods or safe environments, and sources of knowledge. The social aspect of community-based health considers the relationships with institutions, professionals, and coaches.

Kelley said access to resources and environmental factors can best be addressed when the community members are included in the creation of programs.

“The more in touch communities are with the needs of their members, the better they can create supportive environments to promote their health,” Kelley said.

When health institutions, professionals, and coaches take the time to prioritize the needs and perspectives of the community they are working with, community leaders are more likely to feel invested in the programs as well, Kelley said.