I recently attended Canadian Pension & Benefits Institute’s Forum in Boston. A theme that emerged loud and clear from the majority of the speakers on the topic of benefits was that employers need to take a more active role in helping their employees manage the chronic conditions with which they are living and working. I wholeheartedly agree. But what if these employees struggle with health literacy?
Health literacy is defined as “the degree to which individuals have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions.” The Canadian Council on Learning reports that 60% of Canadian adults and 88% of Canadian seniors do not have adequate health literacy skills, and that a high degree of everyday literacy does not necessarily translate into a high degree of health literacy.
Why do employers need to take notice of these statistics? Employees who have a low level of health literacy drive higher costs than those who are health literate through higher drug, health and disability claims, lower productivity and higher absenteeism. People with low levels of health literacy are less able to manage their chronic health conditions, have more complications and a more rapid disease progression, have more frequent and longer hospital stays, are more likely to use medications inappropriately or ineffectively, and are less likely to engage in preventive behaviours. Most important, they are overwhelmed by healthcare and are less likely to be compliant to treatment or to effectively manage their own health. In essence, low health literacy creates a barrier to care.
Many employers have expended a great deal of energy and resources in promoting smart consumerism to their plan members. Consequently, many plan designs include cost containment features that reward plan members who engage in smart consumerism. These efforts may be lost on, or at minimum not effectively delivered to, plan members with low levels of health literacy.
Also of note is the high percentage of Canada’s seniors who struggle with health literacy: while this demographic is not likely a large part of your working population, their caregivers are. Low levels of health literacy in the parents, aunts, uncles and even spouses of your employees drives more time away from work as they go with them to appointments, spend time with them in hospital, talk to their practitioners and make arrangements for healthcare on their behalf.
So what can employers do about this issue?
- Educate employees about health and wellness, and the role they play in manage their own health.
- Consider the addition of eldercare support services to your benefits plan. If your benefits program includes an employee and family assistance program (EFAP), promote the availability of eldercare support already available to your employees.
- Make sure your employees and their families have access to credible sources of health and wellness information–most insurers and many EFAP providers now include health information or links to credible sites for health information on their plan member portals or microsites.
- When developing or implementing wellness initiatives, consider that your audience may have differing levels of health literacy.
- Take a critical look at any communications material your organization uses to drive plan member action. This can include enrolling in the benefits plan, choosing flex plan options, making changes to benefits after a life event, promoting smart consumerism, participating in a wellness activity, or making conversion decisions when leaving your group. Do your materials adequately explain the consequences of an employee’s decision or indecision? Do you have a glossary available in plain language or other help?
- Consider the role that advocacy could play for your plan members and how you might incorporate advocacy into the resources and services you make available to your employees and their families.
Navigating our healthcare system is complex at the best of times. Navigating healthcare when you have a chronic health condition can feel infinitely more complex. Improving the health literacy of plan members will absolutely improve both the health of employees, and health and disability claims experience for plan sponsors. Perhaps this problem deserves more attention and strategic focus as we work to improve the health of our employees and their families.