Health education: Corona shows gaps

Medical knowledge is growing faster and faster - among experts. However, laypeople often find it difficult to deal with the complex relationships. Why the “National Health Literacy Action Plan” is becoming increasingly important

Problems with health communication: What experts advise often does not go down well with laypeople

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The following text reflects the views of Doris Schaeffer, Klaus Hurrelmann and Sebastian Schmidt-Kaehler on behalf of the office of the action plan. You have analyzed how the population's competence in the area of ​​health should be strengthened:

Information deficits in a large proportion of the population

Even before the corona crisis, the population's low "health literacy" was an urgent issue. This term is understood to mean the ability of citizens to deal confidently with health information - i.e. to search for news and findings in a targeted manner, to understand them, to fight their way through the variety of right and wrong information and all of this in the end towards their own life situation transfer. A representative study by Bielefeld University on the health literacy of the population in Germany already showed in 2015 that more than half of the citizens have great difficulties with this.

In response to these irritating results, a group of experts developed the "National Action Plan for Health Literacy" in 2018. At the invitation of Bielefeld University and the Hertie School of Governance in Berlin, under the patronage of the Federal Minister of Health, a good dozen experts from science and practice viewed all scientific studies on this topic for over a year.

How to increase competence step by step

From this they derived 15 recommendations, which should serve to gradually increase the competence of the population to deal with health-related questions and to derive the right solutions for themselves. From health education in kindergartens and schools to health management in companies and authorities, strengthening the health-promoting role of municipalities, shops, restaurants and media to improving health communication in medical care facilities and nursing homes - suggestions were made for all living environments, such as laypeople and Professionals can be enabled to deal competently with health information.

The 15 recommendations

1-5 Promote health literacy in all living environments
1. Enable the education system to begin health literacy development as early as possible on the life cycle
2. Promote health literacy at work and in the workplace
3. Strengthen health literacy in dealing with consumer and nutritional offers
4. Facilitate the use of health information in the media
5. Enabling the municipalities to strengthen the health literacy of their residents in the residential areas

6-10 Making the health system user-friendly and health-competent
6. Establish health literacy as the standard at all levels in the health system
7. Facilitate navigation in the health system, increase transparency and reduce administrative hurdles
8. Make communication between health professions and users understandable and effective
9. Make health information user-friendly
10. Facilitate and strengthen patient participation

11-14 Living with a chronic illness as a health literate
11. Integrate health literacy into the care of people with chronic illnesses
12. Enable and support a health-competent approach to disease and its consequences
13. Strengthen the self-management skills of people with chronic illness and their families
14. Promote health literacy to cope with everyday life with chronic illness

15 Systematically researching health literacy
15. Expand research on health literacy

In times of the Corona crisis, these 15 recommendations of the National Action Plan receive an undreamt-of urgency. While there was a lack of information at the beginning of the pandemic and there was hardly any information to guide action to be found, there is now a veritable flood of news. The pandemic is accompanied by an "infodemic". The amount of information about the coronavirus, it seems, is growing much faster than the infection numbers themselves, and this information is extremely difficult to decode. Since the virus set course for Europe, the epidemiologists, infection and hygiene medicine specialists have come to an hour. The citizens get to know the Robert Koch Institute and follow the words of its president with fascination. You get to know the concept of "herd immunity" and are encouraged to deal with the course of infection curves. Many epidemiologists give the impression that you have to understand the dynamic course of the pandemic in order to be able to assess whether you or your closest relatives belong to a "vulnerable group" or are even in mortal danger.

The population is unsettled by the "infodemy"

What matters to people in such an exceptional situation is a mixture of contradictions, uncertainties and barely understandable technical terms. The large number of corona tickers, completely overloaded telephone hotlines and social networks do not make the situation any better. In times of irritation, fake news spreads virally on the internet and causes panic and misjudgment of the current situation.

If you want to get your own picture of the situation, you have to research dozens of places in various media.Most of the time, the laboriously found information is not suitable enough for the respective target group. Especially when it comes to the elderly, people in need of care, disabled people or the homeless.

Excessive demands lead to fears in the population

These observations show that health literacy is an indispensable prerequisite for health-conscious behavior right now. In view of the corona pandemic, this competence is becoming more and more important, especially since with the virus new questions are on the agenda every day, for which new information is required. And so the current situation looks like an exaggerated caricature of what was complained about before the Corona: excessive demands in dealing with medical information and technical terms, disorientation in the multiple instances of the health system and an inadequate and confusing counseling landscape.

he fear is about. The virus shows us limits. Nothing is as it was before. No reliability of familiar rules and habits, no stability, no continuity, no security. Fear is always a result of uncertainty and insecurity. Information can create fear, but it can also convey security and take away unfounded worries. In times when uncertainty 'only' leads to large quantities of toilet paper being bought and disinfectants being stolen, the excesses of fear still seem justifiable. But that can change quickly in the next few weeks under worsened circumstances.

Medical staff should be trained in health communication

Everything now depends on strengthening the health literacy of the population, as outlined in the National Health Literacy Action Plan. The plan is now given a new meaning, especially since it shows how extensive all measures must be if they are to achieve their goal: The 15 recommendations of the plan emphasize the importance of the personal abilities of every citizen to improve the competent handling of information, and this must be started in the education system and in the media.

At the same time, it is pointed out that proportion-oriented measures are necessary, i.e. the everyday worlds of people, including doctors' surgeries and hospitals, are designed in such a way that they make it easy to develop health literacy. This is only possible with professional staff trained in good health communication.

Educational signs instead of barrier tapes

Facilitating the acquisition of health literacy means, for example, not only blocking playgrounds with plastic tape (which is torn after an hour), but also using signs to explain why and for what purpose the blockade was erected; to make clear in the parks that and why one should keep a distance from other people; explain hygiene rules in front of the cleaning shelves in grocery stores. And further: How is it possible for families with many children who live in a residential area without a balcony to ensure sufficient exercise in the fresh air and areas of retreat?

The challenge is great: How can all this information be designed in such a way that it is easily accessible but also understandable and, even more, can be used specifically for personal health maintenance? The location of the addressees must always be taken into account when creating information. Just to believe that the presentation of the correct facts and figures makes the information user-friendly and accessible and that it is automatically transferred into correct action - that is a fallacy.

Looking to the future: long-term tasks

In addition to the current efforts to ensure an effective supply of information during the state of emergency, it will be important to learn the right lessons from the corona crisis in the long term. It will not be enough to stock up on respirators and wrap the whole country in plexiglass. It will be about combating collective fear with information and knowledge and in this way regaining trust. It is about countering the virus through decisive measures, but also ensuring that Corona does not leave any trauma to society as a whole.

The good news is that a number of drugs have long been available to combat such long-term effects: information, education, advice, communication. In combination with a high level of health literacy among the population, a health-promoting environment and a user-friendly health system, these "social drugs" can be very effective.

The National Action Plan to Promote Health Literacy lists all of these points, making it more topical than ever. The question of how health literacy can be strengthened and promoted will determine how our society deals with the pandemic and its consequences.