International Guest Blogger - Melanie A. Prince, President of Case Management Society of America (CMSA)

Health Literacy:  Geography Matters

By Melanie A. Prince, RN, BSN, MSN, NE-BC, CCM, FAAN

Health literacy is an imperative to improve the health of patients and promote the family’s ability to support client care.  I am excited to share a few comments in response to Circle Case Managament's invitation to participate as an international guest and representative of the Case Management Society of America (CMSA).  I chose this topic because health literacy skills are vital competencies for patients/clients anywhere in the world.  However, geography matters because health literacy is personal, individualized and informed by social determinants of health (SDOH) in the context of patient/client’s capabilities, capacity and environment. 

The United States Centers for Disease Control (CDC) defines health literacy in the Healthy People 2030 Initiative as “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.” (www.cdc.gov) Further, the definition has changed from the 2020 version to incorporate the idea of utilization of health information as well as the application of a public health viewpoint.

No matter what country a patient/client is in, the individual’s capability to acquire, interpret and use health information is influenced by a locality’s resources and social context. The capacity to interpret health information is impacted by what is communicated via media, television, social media, community gatherings, neighbors or family members, to name a few.  For example, there may be locations where internet resources are not available or limited due to technology or broad-band access.  Patients/clients may visit health professionals infrequently and not have the opportunity to receive evidenced-based health information routinely or timely.  In some environments, the opposite may be true; where clinicians adopt a more paternalistic approach and make health decisions for patient/clients, with the belief these decisions are in their best interest.  In some parts of the United States, there are cultural customs and beliefs that shape the perceptions and interpretation of health information provided to patients/clients. The same is true in various parts of the world.

Not only does geographical culture influence how health information is used but also SDOH may impact health literacy skills. Social determinants of health consider the individual’s overall context of their lives, in terms of economy, education, access to health care, a person’s neighborhood and social or community circumstances. All of these circumstances are assessed within the boundaries of a patient/client’s geography. 

In summary, health literacy is vital to a patient/client’s ability to acquire and use health information to achieve health-related goals and improve overall wellness.  While health literacy is important in any country, the acquired skills are dependent upon individual locality, capacity and social context where one lives.  Culture and social determinants of health conditions are significant influencers on health literacy skills.

At CMSA, our focus on SDOH and health literacy as essential elements in health equity empowers our case managers with the necessary tools to impact not only individuals but the entire healthcare system. CMSA has a growing contingent of international members, and we welcome diverse perspectives and ideas. Join here!

Melanie A. Prince is the current President of Case Management Society of America (CMSA). She is a retired active-duty Military Colonel who was assigned to Headquarters Air Force where she was responsible for developing strategies to eliminate interpersonal violence in the military. Melanie is now the Chief Executive Officer of Care Associates Consulting. Melanie is a certified case manager and medical-surgical nurse with over 25 years of progressive leadership responsibilities and diverse clinical experiences in emergency medicine, inpatient care, disaster management, ambulatory health, population health and medical management. Her excitement and confidence in the principles of case management led to the Air Force’s first independent Nurse Managed Clinic staffed exclusively by case managers, where patient outcomes were game changers for medical management and population health. Recognized for fusing business acumen with clinical expertise to launch award-winning programs, Melanie is considered a subject matter expert in case, disease, and utilization management and has won numerous awards including the distinguished CMSA Chapter, 2003 and National Case Manager of the Year, 2004. Melanie is a graduate of Air University in Montgomery, Alabama, where she earned a master’s degree in Military Strategic Studies. She also has a master’s degree in Nursing with a concentration in Case Management from University of Arizona, and a bachelor’s degree in Nursing from University of Louisiana, Lafayette.