Health Literacy Is a Public Health Emergency in the South:  What Student Pharmacists Can Do Now

Author: TraVaughn Walton, PharmD Candidate Class of 2028
Editor: Brentsen Wolf, PharmD

As students, pharmacists, and life-long learners, we understand that not every concept clicks the first time we hear it. Given the rigorous and challenging field of pharmacy, you can likely recall an instance where you could retain a medication’s mechanism of action, indication, adverse effects, and much more, whilst at the same time, you couldn’t pronounce it correctly. Now imagine this from a patient’s perspective. What is a mechanism of action? What is an indication? What are adverse effects? The last thing many patients are worried about is pronunciation. 2024 data from the Center for Health Care Strategies (CHCS) shows that nearly 9 out of 10 adults in the United States struggle with health literacy. CHCS further states that “limited health literacy is most prevalent among marginalized populations,” many of whom live in the South and face the greatest barriers to care. This reality shapes how patients understand medication instructions, risks, and even the basic terms we use every day. 

In this very needed discussion, I will discuss the importance of health literacy, and how student pharmacists are uniquely positioned to break down these detrimental translation barriers, especially where it harms most, the South. 

What Is Health Literacy and Why Should Student Pharmacists Care? 

Defined by the World Health Organization (WHO), “Health literacy means being able to access, understand, appraise and use information and services in ways that promote and maintain good health and well-being.” This definition is important to understand the unique role of a pharmacist. We are usually the first or last health professional a patient consults before making an informed health decision regarding medication. In my role as a pharmacy intern, I consistently see patients receive prescriptions without understanding the medication, the condition, and why it is necessary for their health. However, I have also seen how a simple and clear explanation can completely change a patient's understanding and confidence in taking control of their health. 

This could reduce intimidation for the patient, allowing student pharmacists to identify gaps in understanding that many pharmacists might not have time to delve into, given the hectic environment of many community pharmacies. This is also why pharmacy interns are essential and should be encouraged in every pharmacy. When appropriately collaborating with pharmacists, patients are put at the forefront, ensuring medication safety, verification, and most importantly: understanding. 

My Personal Connection: Health Literacy In The South 

As a Mississippi native, I have made it a priority to reach the communities that need education the most. My own experiences with low health literacy, paired with the impact I have seen from meaningful intervention, shaped this commitment early in my pharmacy career. Through outreach roles in pharmacy school, I quickly noticed the gap between the classroom environment of highly educated students and the reality of the general public, where many Mississippians read at a fourth-grade level. That was when I realized, patient-specific education is not optional; it is necessary. 

The conversations I have during health screenings, diabetes outreach, and wellness events all pointed to the same truth. Patients want to take control of their health, but many are hesitant or anxious because they do not fully understand their medications. What often looks like an adherence issue is really fear. 

I was counseling a mother picking up oral liquid amoxicillin for her child’s ear infection, and before I even began counseling, I could tell she looked unsure. As I explained how to measure and administer the medication, she paused and admitted that she thought the antibiotic was meant to go into the child’s ear, not mouth. She was relieved and thankful that I took the time to explain it, because that was her honest interpretation based on the condition being treated. 

Situations like this remind me that many patients are not “non-adherent.” They are interpreting instructions through the lens of their own experiences and literacy. Effective counseling prevents errors, builds trust, and ensures families feel confident caring for their loved ones at home. With clear information and resources presented in a way that feels familiar and understandable, fear becomes confidence. 

What Student Pharmacists Can Do Today 

Pharmacy students can, and do, make meaningful contributions to increasing health literacy well before graduation. Here are some approaches that will allow you to educate those who need it most: 

1. Use clear, simple, patient-centered language 

● Understanding the culture of the patients you serve in your community goes a long way with patient comfort, allowing for well retained consultations.

● Instead of saying “this is an antihypertensive medication for your cardiovascular condition,” say something like, “this medication helps your heart relax so it does not have to work as hard to pump blood through your body.” 

● For diabetes counseling, it is common to meet patients who have heard the terms “Type 1” and “Type 2” but do not truly know the difference. Using familiar analogies can help. For example: “When you eat, your body breaks food down into sugar for energy. Insulin is the hormone that takes that sugar out of your bloodstream so your body can use it. Think of insulin like a pizza delivery driver. Its job is to take the pizza, which is your sugar, and deliver it into your cells so your body can use it for energy.”

• In Type 1 diabetes, there is no delivery driver (no insulin) at all. 
• In Type 2 diabetes, the driver (insulin) is there, but the car is not working well, so the pizzas never make it from the restaurant to the house. 
• “This medication helps your driver and your car work better, so the sugar can finally get into your cells the way it is supposed to.” 

2. Apply the Teach-Back Method 

When counseling the patient on their medication, make sure to ask, “Can you repeat back how you will use this at home?” Confirm they are aware of what the medication is for, how to store it, and what to avoid. This ensures they feel comfortable walking away from the pharmacy with an understanding of their condition and medication. 

Through my personal experience as a pharmacy intern, the teach-back method consistently reveals misunderstandings that would have been missed without the empathy and motive to ensure the patient leaves with a full understanding. 

3. Demonstrate devices, hands-on 

Blood pressure cuffs, glucose monitors, and inhalers all have instructions listed, but with the adult literacy level of Mississippians in mind, most patients will not understand or read those instructions. This makes hands-on demonstration one of the most effective strategies student pharmacists can integrate into practice for patient understanding and adherence. Allowing the patient to demonstrate the correct method taught avoids misuse at home. 

4. Bringing health care education outside of traditional settings 

Community events in locations such as churches, barber shops, and local community centers allow students to reach people who are not always keeping health at the forefront of their minds and who rarely make it to the clinic. 

Taking these 4 simple steps as student pharmacists can prevent months of uncontrolled disease and save thousands of dollars. 

Student Pharmacists Superpower: Organizations 

In pharmacy school, there are a plethora of opportunities to get involved. Through organizations such as APhA, NCPA, SNPhA, and many others, we can engage our community through educational outreach events. I encourage student pharmacists to involve themselves in these organizations. Not only do you get the chance to develop professional leadership skills, but you also get to make an impact in the community you serve. 

As the Fighting Diabetes Initiative Chair at the University of Mississippi’s SNPhA chapter, I continuously find ways to reach the community I serve by educating and providing crucial information to patients. Tailoring your outreach to communities with lower health literacy improves the public health literacy emergency in real time. Being a part of this change is crucial for the future of patient care and pharmacist-led interventions.

Quality Improvement: Evaluating Community Impact and Sustainability 

Quality improvement is not only a tool for measuring outreach outcomes. It is a core part of our profession, ensuring that pharmacist-led interventions remain sustainable, evidence-based, and adaptable to the evolving needs of the communities we serve. 

With organizations being student pharmacists’ superpower, the data we collect from these outreach events holds just as much power. Quality improvement data is particularly necessary for improving health literacy. This data helps us track outcomes and measure the need for intervention. Some questions I recommend you ask yourself and assess with your fellow members after outreach events include: 

● How many people did we reach? 

● What can we do to reach more people? 

● How many people left with a better understanding of their health, and how are we measuring this? 

● How can we ensure this intervention sustains after my term and involvement in my organization? 

These questions guide improvement for future events and ensure that our efforts to strengthen understanding, adherence, and health literacy remain meaningful. By consistently evaluating our impact, student pharmacists can refine outreach, identify gaps, and build interventions that truly support the patients and communities we serve. 

Conclusion: Building a Health Literate Future 

Imagine a future where patients feel confident managing their medications, where questions are welcomed, and where clear communication feels natural and consistent for every individual patient. Health literacy is the foundation for that future. If we want to change the way patients respond to their medication, we must first address the most common barriers: communication, understanding, and education. 

Student pharmacists have the power to spark this change in real time. In pharmacies, in our communities, and in every conversation we have with patients, we can model the kind of care that transforms fear into confidence. Bringing attention to health literacy today sets the stage for communities to thrive in their health journeys and creates a ripple effect for student pharmacists who will follow in our footsteps. 

Start early. Start now. Start for the reason you chose this profession, to improve patients’ health and change lives through understanding.

Author Bio

References 

1. World Health Organization. Health literacy. World Health Organization; 2024. https://www.who.int/health-topics/health-literacy 

2. Center for Health Care Strategies. Health Literacy Fact Sheets. Center for Health Care Strategies; 2024. https://www.chcs.org/resource/health-literacy-fact-sheets/ 

*Information presented on RxTeach does not represent the opinion of any specific company, organization, or team other than the authors themselves. No patient-provider relationship is created.