You’re handed a leaflet.
Or a portal login.
Or a diagnosis.

And you’re expected to understand.
To act.
To comply.

But what if health literacy isn’t just about absorbing information?
What if it’s about a relationship?

Let’s spiral into how health literacy, when held as relational practice, becomes a tool for equity, empathy, and co-created care.

Health literacy is the ability to:

• Access health information
• Understand it
• Evaluate it
• Apply it to make informed decisions

But as Health Education England’s guide reminds us, health literacy is also a systemic issue.
It reflects how health information is communicated, and whether systems are designed to support understanding.

It’s not just about the patient’s ability.
It’s about the system’s responsibility.

Traditional health literacy assumes:

• One-way communication: “We tell, you learn.”
• Standardised formats: Leaflets, portals, jargon-heavy consultations
• Compliance over connection: “Follow the instructions.”

Relational health literacy shifts this by:

• Co-creating understanding: “What do you need to know?”
• Building trust: “What matters to you?”
• Adapting formats: Visuals, metaphors, teach-back, plain language
• Honouring emotion: “How do you feel about this?”

As BMC Health Services Research notes, effective communication is central to organisational health literacy, especially in transcultural settings.

In inclusive spaces, health literacy must be:

• Trauma-informed: Sensitive to histories of medical harm or mistrust
• Culturally resonant: Reflecting diverse beliefs, languages, and metaphors
• Emotionally safe: Free from shame, pressure, or jargon
• Relationally held: Built through dialogue, not instruction

As the European Research Studies Journal highlights, relational communication improves patient empowerment, health awareness, and therapeutic outcomes.

Want to practice relational health literacy? Try these:

Teach-back technique: “Can you tell me how you’d explain this to a friend?”
Chunk and check: Share info in small pieces, then pause to confirm understanding
Use plain language: Swap “hypertension” for “high blood pressure”
Offer multiple formats: Visuals, audio, easy-read, translated materials
Ask open questions: “What’s most confusing or worrying right now?”
Use metaphor and story: “Think of your lungs like balloons…”

These aren’t just communication tools.
They’re relational rituals.

Let’s name it:
Health literacy isn’t just a skill.
It’s a design challenge.

Systems must:

• Build feedback loops
• Train staff in emotional and cultural literacy
• Create accessible materials
• Value patient voice

As NIHR Evidence shows, improving health literacy requires systemic change, not just individual effort.

Relational practice means designing for understanding, not just information delivery.

Health literacy isn’t a test.
It’s a conversation.

So next time you share health information,
Pause.
Ask.
Listen.

Because in a world of leaflets and logins,
Understanding begins with a relationship.

Explore more with us:

• Browse Spiralmore collections
• Read our Informal Blog for relaxed insights
• Discover Deconvolution and see what’s happening
• Visit Gwenin for a curated selection of frameworks