Being able to comprehend your own health issues makes a significant difference in your overall health outcomes. By following instructions, reading, correctly administering prescriptions, understanding your diagnosis, prognosis, and treatment—you will determine what happens to you and how well you live... perhaps even how long you live.
The Institute of Medicine reported that ninety million people in the United States (slightly less than a third of our population) have problems appreciating health information, resulting in patients often not taking medications correctly, missing follow up appointments, and having the added worry of not understanding what is happening to them.
According to the American Medical Association, poor health literacy is "a stronger predictor of a person's health than age, income, employment status, education level, and race." This fact is from a report on the Council of Scientific Affairs, Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association.
Health literacy is defined in Healthy People 2010 as: "The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions."
Health literacy includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctors’ directions, and consent forms, and to negotiate complex health care systems. Health illiteracy is not limited to people who cannot understand, read, or write English. However, this deficiency is a significant first barrier which needs to be overcome before proceeding to the more advanced step of taking an active role in one’s health.
Assisting everyone to be fluent in English is a great start. International Literacy Day is September 8th, as designated by the United Nations. Understanding and reading one’s native language along with the prevailing community’s language is just the beginning. Health literacy requires a complex mixture of reading, listening, analytical and decision-making skills, along with the ability to apply these skills to health situations.
Among the populations at greatest risk are the elderly. Two-thirds of U.S. adults age 60 and over have inadequate or marginal literacy skills. According to a recent JAMA article, 81% of patients in this group at a public hospital could not read or understand basic materials such as prescription labels. Some members of minority populations, recent immigrants, people with chronic mental and/or physical health conditions and certain low income folks—approximately half of Medicare/Medicaid recipients, read below the fifth-grade level http://www.medicarerights.org/maincontentstatsdemographics.html).
Not surprisingly, there are serious economic consequences because of health illiteracy. These folks have 6% more hospital stays and make more visits to emergency rooms. Unfortunately, they also have fewer office visits; preventive care, which is far less expensive, is more likely to be administered out of the hospital setting.
We can and should do better with health literacy. Highlighting the gap between sending out a message and having the message received is just the beginning. People fluent in English are at risk, and our non-English proficient neighbors are at even greater risk. Helping both groups will have a significant positive affect on the individuals, their families, and our community. We should address the problem sooner rather than later.