Opinion: It's time for a health literacy law in Texas

This past year, Mount Pleasant became a hotspot for COVID-19. Why was this small rural community in East Texas susceptible to an outbreak? The residents are predominantly employed by local agriculture and manufacturing industries, which require working in close quarters. Language barriers and rapidly changing discoveries about the virus and vaccines created confusion, particularly within the Latinx population already burdened with difficulty understanding health information.

This example describes the issue of health literacy: the ability to obtain and understand basic health information and services to make appropriate health decisions. Eighty-eight percent of Americans struggle with health literacy at one time or another, no matter their language or demographics, making it a threat to our public health. Rural communities are far from alone.

Although health literacy potentially impacts all Texans, it does not seem to be a priority for our state lawmakers. This is alarming, as we are currently experiencing a health information infodemic, a flood of poorly understood health information. The COVID-19 pandemic has shown that poor health communication, and health misinformation, have potentially fatal consequences. Low health literacy results in significantly worse health outcomes such as poor adherence to treatment plans, increased emergency room and hospital stays, and even death, which exacerbate increasing medical costs, estimated at $215 billion annually.

As medical educators, we work to embed health literacy into the curricula at our health science centers. Emerging health professionals receive instruction in clear communication. They learn the power of using plain language, conveying information into digestible bites, and checking for understanding. Using these techniques, they can empower patients to navigate the complexity of health care for themselves and their loved ones. In other words, they become a conduit for health literacy.

In medical schools, however, we rely on stolen course time to teach health literacy, since there is no mandate through accreditation or other requirements. It is imperative we find a sustainable way to transform health care.

The 87th Texas legislature just debated HB 578, a bill that defines health literacy and calls for the establishment of an advisory committee to make plans to improve health literacy. It would acknowledge the impact health literacy has on health outcomes and push long-needed health literacy initiatives forward.

Legislative support to create an organized, statewide plan to address health literacy could promote:

• drawing attention to the increased circulation of health misinformation 
• organizations to adopt health literacy polices
• medical schools to make the case for including health literacy in the required curriculum
• hiring community health workers to bridge the communication divide
• foundations investing in health literacy initiatives in their local communities
• creating a culture of health literacy that supports people at all levels of society

Unfortunately, for the third time, the bill failed to pass into law.

In response, Health Literacy Texas, a statewide health coalition, recently formed to bring a cohesive approach to improving the health literacy of all in our large, diverse state. We held our inaugural conference on June 24. More than 200 people from across the state came together to tackle our most pressing health issues. This includes strategizing advocacy for a bill that paves the way to make health literacy a recognized priority for our state.

As the pandemic has made clear, Texans suffer from a lack of a health literacy infrastructure. The inequities caused by low health literacy are real. It is imperative, now more than ever, for health care professionals and health literacy advocates to make our voices heard by legislators.

Health Literacy Texas aims to ignite the movement to a culture of health literacy in Texas. It is time for our state lawmakers to come on board.

Stone is vice president and Wagner is president of Health Literacy Texas.