Response: Health Literacy Training Critical for Medical Residency Transformation in the United Arab Emirates.

Health Literacy Training Critical for Medical Residency Transformation in the United Arab Emirates To the Editor: The recent publication of the article, “Improving Health Equity Through Health Literacy Education,” (Nepps et al., 2023) advances the health literacy mission in a bold and balanced manner. Inadequate health literacy is known to be a stronger predictor of poor health outcomes than all other sociodemographic variables, including ethnicity (Levic et al., 2023). Given the lack of an exact estimation of population health literacy levels in various countries, the global health care work force is oblivious to the perils of poor health literacy (Zimmerman & Woolf, 2014). Health care providers lack adequate knowledge and skills to work effectively with patients who possess limited health literacy, especially in countries with multiethnic, multicultural populations (Nair, Sreedharan, et al., 2023). Among the Gulf cooperation council countries, Saudi Arabia and the United Arab Emirates have reported adequate health literacy rates for patients ranging from 24% to 44% (Nair, Al Saraj, et al., 2023). Recently, two studies assessing health literacy have reported adequate health literacy among 14.3% of patients with cardiovascular diseases, and 11% among patients with type 2 diabetes in the United Arab Emirates (Nair, Al Saraj, et al., 2023; Nair, Sreedharan, et al., 2023). These studies also noted alarmingly low patient health literacy levels in older adult patients. It is noteworthy that less than 10% of the total population in the United Arab Emirates are citizens; most residents are immigrants from various parts of the world, many are unskilled workers from southeast Asia. Incidentally, there are no published reports of health literacy training for medical resident trainees in the United Arab Emirates. Health system reforms are essential, given the high prevalence of cardiovascular diseases and diabetes, and their association with low health literacy levels in the United Arab Emirates. Transformation of medical residency programs to routinely integrate health literacy best practices in all patient encounters, as well as restructuring of medical education to focus on disease prevention and biopsychosocial models of care, whether in the United Arab Emirates or elsewhere, are essential reforms required for sustainable health equity.