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For nearly a decade, Merck’s employee business resource groups have played a central role in the development, refinement and execution of the company’s global health literacy strategy.
Employees at Merck work hard to develop and deliver innovative medicines and vaccines. However, patients do not fully reap the intended benefits of medical inventions unless they understand their diagnosis and treatments, the possible side effects of therapy, and how to take their medicines correctly. These skills depend on health literacy.
Health literacy is a strong predictor of a person’s health status – more so than race, religion, gender, income or employment status. Unfortunately, low health literacy is a problem of global magnitude. In the U.S., only 12 percent of adults have proficient health literacy. In Europe, about one of every two people has poor health literacy.
Merck’s employee business resource groups (EBRGs) understand the impact of low health literacy on at-risk populations. Communities with ties to employee affinity groups are often particularly vulnerable to health literacy challenges, including racial and ethnic minorities, older individuals, immigrants with English as a second language, and individuals with low income.
The company’s health literacy initiative includes EBRGs as a key stakeholder, recognizing the groups have a profound influence on engaging employees within the workforce and connecting with communities outside of the workplace. The cultural insights and perspectives afforded by the EBRGs have helped to inform and advance Merck’s health literacy strategy in numerous impactful ways.
“As one of only two pharmaceutical companies that have a dedicated resource for health literacy, Merck is working hard to improve patient communications. Arming patients with the knowledge and skills to make informed health decisions can help us reach our goal of improving public health. Clear communication must be part of the care… and the cure.”
-Laurie Myers, Director of Global Health Literacy, Merck
Providing cultural insight to better represent diverse groups in the content of clinical trial education materials
Merck is piloting a clinical trial investigator resource on health literacy and cultural sensitivity with the goal of increasing the participation of underrepresented populations. The resource includes images of people from a range of backgrounds to reflect today’s diverse healthcare settings and providers. Initially, the company was unable to secure participation of people of Muslim faith in the material development. The company’s interfaith EBRG was instrumental in establishing a dialogue with the community to garner their input and involvement. As a result, the new resource includes photos that represent the range of diversity in both provider and patient populations. The messaging is subtle, but impactful. Often this diversity is not captured in clinical trial materials without a conscious intent.
What is Health Literacy?
Health literacy is commonly defined as the degree to which individuals have the capacity to obtain, process, understand and use health information and services to make appropriate health decisions. It includes the skills necessary for an individual to participate effectively in the health care system and maintain good health. These skills include reading and writing, calculating numbers, communicating with healthcare professionals, navigating health information, and using health technology. Education, language, culture, access to resources, and age are all factors that affect a person’s health literacy skills. Low health literacy is more likely to result in poor health outcomes. The communication skills of the people and organizations providing health information and services can help to empower patients to make informed choices.
Providing cultural insights for patient education about health conditions
An important strategy to address low health literacy is to present information in visually accessible formats. When the company developed educational resources about diabetes and diet, they created “plates” of food, using photos of food healthy for diabetics. EBRG members provided important insights to ensure that the food plates were culturally appropriate and relevant. The input of the EBRGs helped connect the message with communities at higher risk for diabetes. The company recognized the opportunity to improve the diversity of images about other health conditions. Drawing upon input from EBRGs, artwork included in health literacy resources depict realistic urban settings and multi-ethnic, multi-generational images. The input of the EBRGs also ensured greater diversity within a specific culture. For example, images of Asians include people not only from China and Japan, but also Vietnam. Hispanic imagery traditionally featuring Mexican Americans was expanded to include images representing people from Cuba, Puerto Rico and Latin America.
Ongoing opportunities for EBRG members to learn about health literacy
Merck offers employees one-day training sessions in health literacy, numeracy, and cultural competency. To date, over 1,000 employees have participated, including many members of EBRGs. In 2017, the company brought in a national expert to speak directly with EBRG leaders about the link between health literacy and diversity. In 2018, EBRG members around the world participated in three webinars to drive awareness of Merck’s health literacy initiatives and provide employees with actionable steps to integrate health literacy into their personal and professional lives. Today, many of the EBRGs organize their own activities to engage their members in advancing health literacy. For example, Merck’s employee-led League of Employees of African Descent engaged employees in healthy eating events to support Health Literacy Month.
Merck is committed to increasing global awareness of the importance of health literacy and advocating for regulatory policies which empower patients to make informed decisions about their health. The EBRGs at Merck play an integral role in advancing the company’s health literacy efforts. Across the enterprise, employees work to implement health literacy principles into domains including clinical trial materials, patient education, and packaging, modeling how clear communication can help improve health literacy in communities around the globe.
U.S. Snapshot:
- Low health literacy creates an estimated $4.8 billion annual administrative cost burden for payers
- An estimated 90 million Americans have low health literacy
- Nearly nine out of ten adults may lack the skills needed to manage their health and prevent disease
Sources: Accenture study: The Hidden Cost of Healthcare System Complexity. Center for Healthcare Strategies: Fact Sheet. U.S. Department of Health and Human Services.
