A 45-year-old Hispanic immigrant undergoes a job-related health screening and is told that his blood pressure is very high. He goes to the local public hospital and is given a prescription for a beta-blocker and diuretic, each to be taken once a day. One week later, he goes to the hospital after experiencing dizziness. His blood pressure is very low, and he says he has been taking the medicine just like it says on the bottle. The case is discussed by multiple practitioners until one who speaks Spanish asks the patient how many pills he took each day. “Twenty-two,” he replies. The provider explains to his colleagues that “once” means “11” in Spanish.—Help Patients Understand, American Medical Association
Defining Health Literacy
- Health Literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.—Patient Protection and Affordable Care Act of 2010, Title V
- Health literacy includes reading and writing skills necessary to understand health and medication information. It is also an individual’s ability to complete complex forms, locate available health providers and services, share health history, and negotiate signage at health care facilities.
- Health literacy includes numeracy skills for such things as understanding cholesterol and blood sugar levels, measuring medications, and understanding nutrition labels.
- Health literacy includes effective communication between health care professionals and patients with low literacy skills and/or individuals with limited English.
Why is Health Literacy important?
- Nearly 9 out of 10 adults have difficulty using the everyday health information that is routinely available in our healthcare facilities, retail outlets, media and communities.—Centers for Disease Control and Prevention
- Current data indicates that more than a third of American adults—some 89 million people—lack sufficient health literacy to effectively undertake and execute needed medical treatments and preventative health care.—AMA Foundation
- Without clear understanding of health literacy information, individuals are more likely to skip necessary medical tests, forgo preventative health measures, and have higher rates of hospitalization and emergency services.—Centers for Disease Control and Prevention
- Persons with limited literacy skills are more likely to have chronic conditions such as high blood pressure, diabetes, or asthma, and are less likely to manage them effectively.—U.S. Department of Health and Human Services
- Poor health literacy is a stronger predictor of a person’s health than his age, socioeconomic status, education, or ethnicity.—AMA Foundation
- Forty-six percent of American adults cannot read and follow medical instructions.—AMA Foundation
- One study revealed the following problems experienced by persons with limited health literacy when they interacted with the health care system (AMA Foundation):
• 26% did not understand when their next appointment was scheduled
• 42% did not understand instructions to “take medication on an empty stomach”
• 78% misinterpret warnings on prescription labels
• 86% could not understand rights and responsibilities section of a Medicaid application.
- Every day, millions of adults must make decisions and take actions on issues that protect not only their own well-being, but also that of their family members and communities. These actions are not confined to traditional health-care settings such as doctors and dentists’ offices, hospitals, and clinics. They take place in homes, at work, in schools, and in community forums across the country. Health-related activities are part of the daily life of adults, whether they are sick or well.—AMA Foundation
- More than 300 studies have shown that health information cannot be understood by most of the people for whom it was intended, suggesting that the assumptions regarding the recipient’s level of health literacy made by the creators of this information are often incorrect.—AMA Foundation
- The combination of medical errors, excess hospitalizations, longer hospital stays, more use of emergency departments, and a generally higher level of illness can all attribute to limited health literacy.
- “Low health literacy is a major source of economic drain in the U.S. healthcare system. An initial approximation places the order of magnitude of the cost of low health literacy t othe U.S. economy in the range from $106 billion to $238 billion annually.” — John A. Vernon, Ph.D., Low Health Literacy: Implications for National Health Policy, 2007
YouTube video (23 minutes)—American Medical Association Foundation, featuring Toni Cordell, former adult learner from Oklahoma
Health.gov— Health.gov from Office of Disease Prevention and Health Promotion