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Improving health literacy may help solve America’s pandemic problems

The USA has a long history of failing to provide health-improving resources to many of its people.

Many scientists spent much of 2020 saying the fastest and easiest way to end the coronavirus pandemic was to develop an effective Covid vaccine. Now that vaccine (actually, multiple vaccines) has been developed. But few experts are calling time on the pandemic because getting jabs into enough arms to avoid new variants evolving is proving to be a bit of a nightmare. In much of the world, this is mainly because of accessibility issues (partly caused by the unequal distribution of vaccines between richer and poorer places). But in some rich countries where the jab is freely available, the major problem is vaccine hesitancy: large chunks of the population are not getting jabbed.

Perhaps the most famous example of this phenomenon is America, where the adult vaccination rate has flatlined at 60 percent. Most people point to politics as the reason. Those who voted for Republican Donald Trump in the 2020 election are 13 percent less likely to be jabbed than average, while those who voted for Democrat Joe Biden are 18 percent more likely to be vaccinated. This voting preference was by far the biggest influence on someone's likelihood of getting vaccinated. Which is not surprising, because Trump and the people and media outlets associated with him have often cast doubt or peddled full-out misinformation on the efficacy of and intention behind the vaccine, while Biden and his allies have promoted vaccination.

But while Republicans may be responsible for the spark, not everyone is convinced they can be held solely to blame for the kindling. Instead, some people have pointed to the country’s poor health literacy, which is "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." The American health department says barely 12 percent of the population could be described as ‘health literate’. One in three cannot easily complete basic health tasks like following prescription directions.

Whose responsibility is people’s health literacy? Some would say individuals are ultimately in charge of their own wellbeing. But many others would argue that gaining these sorts of skills and knowledge is incredibly difficult, if not impossible, without the backing of the institutions and infrastructure that are the purview of governments. An effective national education system could do a lot to improve health literacy, as could an accessible and trustworthy healthcare system. The US arguably has neither. Half of its adults cannot read proficiently. One in eight of its people decided against going to the doctor in the last year because it’s so expensive.

Generally the people who benefit most from government help are those with fewer resources of their own. So when health literacy isn’t being adequately pushed by the state, the odds are it’s the health literacy of the poorest and most vulnerable populations that will suffer the most. From that perspective, it’s interesting to note that some of the other variables that increase vaccine hesitancy are having no educational qualifications, being Black, and earning less than $50k a year.

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