In 2010, Dr. James Plumb approached HCIF with an opportunity: a grant from the Pennsylvania Department of Health to address cardiovascular health communication in older adults in Southeastern Pennsylvania. At the time, HCIF had not considered health literacy in our portfolio of clinical improvement and quality initiatives; more than a decade later, it is a cornerstone of our organizational priorities. Our health literacy initiatives now span the entire state, engage both clinical and community partners, and promote systems-level solutions to improve patient-provider communication. During this time, Dr. Plumb has served as principle investigator, Steering Committee member, health literacy trainer, and physician champion.

As Dr. Plumb retires from his academic appointments at Thomas Jefferson University, we asked him to reflect on his contributions to advancing health literacy in Pennsylvania, and the future of the field.

James Plumb, MD, MPH
Lecturer, Jefferson College of Population Health
Professor, Department of Family & Community Medicine, Sidney Kimmel Medical College
Vice Chair, Community Medicine, Sidney Kimmel Medical College
Co-Director, Center for Urban Health, Thomas Jefferson University Hospital


Tell us about your health literacy a-ha! moment.

I was shaken when I reviewed the literacy levels of the population I was seeing in my clinic in North Philadelphia. I had been working with the population for years and never had thought of the concept of “health literacy”. After learning the teach-back technique, I totally changed my approach at the end of a visit. I encourage providers who are interested in health literacy to ask their next patient to repeat the instructions given for follow-up care, testing, taking medication, etc. They will then realize that all did not go well.

If you could motivate health care professionals to tackle one issue or address one challenge related to health literacy, what would it be?

Use a team approach to care. Orient all staff to the challenges faced by those with low health literacy, and create a shame-free environment.

As you reflect on the past decade of our health literacy work, what moments stand out to you?

At every one of our many trainings, so many participants recognized the challenges and the solutions to providing quality care to all patients, regarding of their literacy level. They left the training with a renewed sense of how to better improve care.

What do you think will change in the field of health literacy over the next five years?

Institutions and providers will realize that both cost and quality will improve when principles and practices of health literacy are in place, measured, and monitored. Institutions must be, and will be, held accountable for ensuring best practices.

What have you found most valuable about working with HCIF? What’s something you’ve learned from our partnership?

The HCIF team has embraced the comprehensive approach to addressing health literacy at multiple levels, particularly when working with immigrant and refugee populations, and in completing well-organized and thorough reports on the literacy initiative. The HCIF team is one of the best groups I have ever worked with.

What’s a quote or experience that inspires you in your work?

The World Health Organization’s Social Determinants of Health Commission stresses “Why Treat People, Without Changing What Makes Them Sick.” Going upstream will advance health equity and social justice.

Finish the sentence, “Health literacy matters because…

patients deserve to make informed decisions.”


HCIF will carry on Dr. Plumb’s legacy in literacy and community health through a renewed commitment to advancing health equity and anti-racism in the three-year grant period starting this July. Our team is grateful to call Dr. Plumb a mentor and colleague; his vision for our health literacy initiatives is the foundation of our population health project portfolio today.

Dr. Plumb will be keeping busy in retirement watching his children and grandchildren grow, training his new Cavalier King Charles Spaniel puppy, shooting his age on a golf course, gardening, hiking, and doing jigsaw puzzles. To keep in touch with Dr. Plumb, you can email him at james.plumb@jefferson.edu.

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