Improving Health Literacy
The US Agency for Healthcare Research and Quality (AHRQ) and the Institute of Medicine (IOM)—a private, nonprofit institution sponsored by the National Academy of Science—have both published reports that urge this country to find ways to improve health literacy.
Why is this so important?
Says the AHRQ report: “Low literacy may impair functioning in the healthcare environment, affect patient-physician communication dynamics, and inadvertently lead to substandard medical care. It is associated with poor understanding of written or spoken medical advice, adverse health outcomes, and negative effects on the health of the population.”
What Is Health Literacy?
IOM defines health literacy as the degree to which individuals have the capacity to obtain, process, and understand basic information and services needed to make appropriate decisions regarding their health.
“Health literacy skills are needed for discussing care with health professionals; reading and understanding patient information sheets, consent forms, and advertising; and using medical tools such as a thermometer,” IOM says.
Health Literacy in the United States
Yet, after analyzing over 300 studies, IOM notes that health-related materials cannot be understood by most of the people for whom they are intended. Researchers from Chicago’s Northwestern University observe that many patients struggle to read and comprehend even the simplest materials commonly encountered in healthcare settings, such as prescription bottles and appointment slips.
Certain factors are known to compound the risk of poor comprehension of health instructions. These include:
- Fewer years of education
- Minority race
- Advancing age
- Female gender
Impact on Health
When it comes to the effects of low literacy, both IOM and AHRQ make it clear that more research is needed. Even so, current evidence suggests that difficulty understanding medical information and instructions may have a profound impact on health.
In a review of 73 studies, AHRQ found that adults with low literacy were less likely to receive routine preventive care such as vaccinations, cancer screenings, tests for sexually transmitted diseases, and prenatal visits. Their children were less likely to receive well-child care. They also had decreased awareness of the health effects of smoking, drugs and alcohol, AIDS, and chronic diseases like ]]>asthma]]> or ]]>diabetes]]> . In addition, the rate of hospitalization and use of emergency services was much higher among patients with low literacy. All in all, this may result in the expenditure of billions of dollars in excess healthcare costs.
IOM agrees that health literacy is fundamental to quality care. The agency warns that if patients cannot comprehend needed health information, attempts to improve the quality of care and reduce healthcare costs and disparities may fail.
Steps for Improvement
“Responsibility for improving health literacy must be borne not only by the healthcare system, but also by educators, employers, community organizations, and other groups with social and cultural influence,” IOM says. The organization has set forth a “Vision for a Health Literate America” in which it foresees patients of the future. These patients are well-informed about their health and are consistently provided with reliable, understandable medical information.
In response to the literacy problem, AHRQ has launched its “Five Steps to Safer Healthcare” campaign. The program features low-literacy publications that can help patients avoid medical errors, take medicine safely, and get appropriate preventive care.
The American Medical Association (AMA) has developed its own health literacy kit. In this case, the purpose is to help member physicians learn to communicate better with their patients. The kit teaches doctors to slow down when speaking, avoid medical jargon, and have patients repeat new information using their own words.
What You Can Do
At the core of the AMA’s Health Literacy Kit is the “Ask Me 3” solution. The idea behind this approach is that you can improve the healthcare you receive by asking your provider three simple questions:
- What is my main problem?
- What do I need to do?
- Why is it important for me to do this?
Changes are occurring rapidly in the medical field: Health systems are becoming more complex. Patients are increasingly asked to take greater responsibility for their own care. In order to do this, they must be able to understand the instructions and basic information they are given. That’s where finding ways to improve the health literacy of our nation can help.
Agency for Healthcare Research and Quality
American Medical Association
Be An Active Healthcare Consumer, Low-literacy guides from AHRQ
Institute of Medicine
Canadian Public Health Association
Baker DW, Gazmararian JA, Williams MV, et al. Health literacy and use of outpatient physician services by Medicare managed care enrollees. J Gen Intern Med . 2004;19:215-220.
Health literacy: A prescription to end confusion. Institute of Medicine, National Academies Press website. Available at: http://www.nap.edu/books/0309091179/html . Accessed April 19, 2004.
Literacy and health outcomes. Evidence report/technology assessment: Number 87. Agency for Healthcare Research and Quality website. Available at: http://www.ahrq.gov/clinic/epcsums/litsum.htm . Accessed April 19, 2004.
Ninety million Americans have inadequate health literacy: IOM report calls for national effort to improve health literacy. Institute of Medicine Media Advisory website. Available at: http://www.nationalacademies.org/news.nsf/isbn/0309091179?opendocument . Accessed April 8, 2004.
Last reviewed June 2008 by ]]>Jill D. Landis, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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