Health Literacy: A Prescription To End Confusion

    A patient in a hospital bed signing a medical form on a chart that a doctor is holding for themThe Institute of Medicine reports that ninety (90) million people in the United States, nearly half the population, have difficulty understanding and using health information.

    As a result, many patients often do not take their medications as prescribed, miss follow-up appointments with their health care provider and do not understand medication instructions like “take on an empty stomach.”

    Health literacy includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor’s directions and consent forms, and the ability to negotiate complex health care systems.

    Health literacy is not simply the ability to read. It requires a complex group of reading, listening, analytical, and decision-making skills, and the ability to apply these skills to health situations.

    People with health literacy challenges tend to be the:

    • Elderly (age 65+) – Two thirds of U.S. adults age 60 and over have inadequate or marginal literacy skills. 81% of patients age 60 and older at a public hospital could not read or understand basic materials such as prescription labels.

    • Minority populations (African American, Latinos, Native Americans, Asians and Hawaiian Islanders)

    • Immigrant populations

    • Low income – Approximately half of Medicare/Medicaid recipients read below the fifth-grade level

    • People with chronic mental and/or physical health conditions

    Reasons for limited literacy skills include:

    • Lack of educational opportunity – people with a high school education or lower.

    • Learning disabilities

    • Cognitive declines in older adults

    Use It or Lose It

    Reading abilities are typically three to five grade levels below the last year of school completed. Therefore, people with a high school diploma typically read at a seventh or eighth grade reading level. The relationship between literacy and health is complex:

    • Literacy impacts health knowledge, health status, and access to health services.

    • Health status is influenced by several related socioeconomic factors.

    • Literacy impacts income level, occupation, education, housing, and access to medical care. The poor and illiterate are more likely to work under hazardous conditions or be exposed to environmental toxins.

    By Dr. James R. Gavin, BDO Diabetes Expert

    Dr. Gavin is Clinical Professor of Medicine at Emory University School of Medicine, Atlanta, GA and at Indiana University School of Medicine, Indianapolis, IN. He also served as President and CEO for MicroIslet, Inc. of San Diego, CA. Dr. Gavin is the past president of the American Diabetes Association and past chairman of the National Diabetes Education Program (NDEP). He is a member of the Institute of Medicine of the National Academies of Sciences.

    Dr. Gavin graduated from Livingstone College in Salisbury, N.C., in 1966 with a degree in chemistry. He earned his Ph.D. in biochemistry from Emory University in 1970 and his M.D. degree from Duke University School of Medicine in 1975, following a postdoctoral fellowship at the National Institutes of Health. He was president of the Morehouse School of Medicine, Atlanta, GA from 2002-2004.

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