President’s Update: June 2022

June 29, 2022 | Wendy Nickel

As the Pennsylvania Health Literacy Summit kicked off earlier this month, we were introduced to A.L, a 39 year-old individual who was an intravenous drug user living on the streets. A.L. had a serious infection and required a hospital stay, but for an individual living with addiction, it was challenging for staff to understand his needs and how to address his myriad health and social challenges. We followed A.L.’s journey to find secure food resources, and then affordable housing, and then pre- and post-natal care for his partner and growing family. Through A.L.’s journey, we learned about inclusion health and how caring for excluded populations helps us to improve care for all.

A.L.’s journey teaches us that inequitable access to care, healthcare disparities, and healthcare harm is often caused by exclusion. By now, many of you have seen the graphic that shows individuals of differing heights standing on the same-sized box trying to see over a fence to view a baseball game. The graphic depicts the continuum from equality to equity. A newer addition to the graphic shows the continuum ending in inclusion, with no fence creating a barrier and the viewers now as participants in the game.

Health literacy is a mechanism to ensure all have the opportunity to be included in healthcare. Imagine an individual who is overwhelmed by a difficult diagnosis and is asked to make a healthcare decision without support or potential understanding. We are perpetuating exclusion when we don’t ensure all individuals have the ability or capacity to participate in their healthcare. Employing health literacy best practices can quite literally ensure that every member of our communities has access to an extraordinarily complex system. Health literacy isn’t just about addressing the individual who speaks English as a second language, or the person who has less than an eighth grade education. It’s also about a paradigm shift to understanding all of the factors which contribute to an individual’s understanding and experience of care.

Health literacy levels the playing field to ensure all are included in healthcare. HCIF is grateful to serve as the lead for the Pennsylvania Health Literacy Coalition and continue to prop the doors open. For more information about our work in health literacy, please visit

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