When patients are presented with a new diagnosis, they are tasked with deciphering this information and navigating their respective health care systems to obtain the appropriate care. Health literacy is essential for patients to make effective decisions. Health literacy is defined as the ability of an individual to obtain and translate information to maintain their own health care.¹ It also allows patients to make informed decisions about their care, especially in instances where they are faced with multiple options. Unfortunately, poor health literacy is not uncommon in the United States—a study found nearly one-third of patients had “basic” or “below basic” health literacy in their cohort.² And providers often overestimate patients’ level of health literacy, with this overestimation disproportionally affecting African American patients.³

The high prevalence of poor health literacy has garnered interest among researchers in multiple fields. Coleman et al recently showcased how tailoring our communication to be more inclusive of those with lower health literacy can improve access to care for minority patients.⁴ Another study by Carroll et al found that tailoring discharge medication information to varying health literacy levels decreased the number of medication errors in pediatric patients.⁵

When studying how health literacy impacts urologic patient outcomes, many investigators have found that patients with poor health literacy tend to have worse outcomes. Scarpato et al found that poor health literacy is associated with higher tumor staging at diagnosis of bladder cancer, poorer nutritional status, lower rates of compliance with follow up, and higher rates of minor complications.⁶ In a study focused on prostate cancer, Joyce and colleagues discovered that lower health literacy was associated with treatment-related regret.⁷

We must further our work regarding health literacy by developing tools within our practices that ensure the information we deliver to our patients is at the appropriate level. Some groups have been successful in creating patient-centered pathology reports for bladder and prostate cancer by combining the expertise of pathologists and patient focus groups.^8-9 These types of initiatives highlight the importance of incorporating the patient perspective when developing these tools as their viewpoints are essential in this space. Currently, there are studies investigating how artificial intelligence can be used to create patient-centered information regarding urologic disease processes. Eppler et al utilized ChatGPT to create layperson summaries of specific urologic studies and found that these summaries were both accurate and easy for the average person to read.¹⁰

Future urologic care needs to cater to the needs of all patients, no matter their educational background or level of health literacy. Poor health literacy can lead to unfavorable outcomes; thus, the first step to address this issue is to assess our patients’ health literacy levels. Further work needs to be done in this area with the goal of creating patient-focused material that can be tailored to fit patients of all educational levels, as this will enable us to improve health outcomes for all our patients.