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Low Health Literacy Endangers 90 Million Americans

Is your doctor even speaking the same language as you are?  Even if she is, many Americans are still unable to understand what their doctor is saying.  In a report finding that 90 million Americans have trouble understanding medical advice, the Institute of Medicine calls for changes to eliminate the costs of consumer confusion.

By: Lesley Michael

4-8-04

The Institute of Medicine’s (IOM) Committee on Health Literacy released their report titled, “Health Literacy: A Prescription to End Confusion,” attempting to address their finding that over 90 million Americans have difficulty comprehending and complying with health and medical advice.

Following the report’s startling discovery after two years of documenting hundreds of cases of misunderstandings, these subsequent steps were proposed:

• The Department of Health and Human Services should take the lead in developing uniform standards for addressing health literacy;

• Government and private funders should support the development and use of culturally appropriate new measures of health literacy, as well as multidisciplinary research on the extent, associations, and consequences of limited health literacy; 

• Educators should take advantage of opportunities to incorporate health-related tasks, materials, and examples into existing lesson plans;

• Professional schools and continuing education programs in the health fields should incorporate health literacy into their curricula and areas of competence; and

• Health care systems should develop and support demonstration programs to establish effective approaches to reduce the negative effects of limited health literacy.

The IOM defines health literacy as, “the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions.” Yet health literacy is not simply contingent on one’s level of education or reading ability; the report’s brief maintains that among other factors, health providers, health administrators and the media must share the responsibility and begin to respond to patients’ and consumers’ abilities.

If much of the health literature widely available to the public is written in English at a tenth-grade reading level and the average person in the U.S. has a  reading ability at a sixth-grade level, is lack of patient comprehension fully to blame?

Maybe bilingual packaging, informational brochures and informed consent forms should be utilized. And, maybe drug companies should come realize that most Medicare patients will have difficulty reading the miniscule-sized warnings accompanying medications.

William A. Smith, Ed.D., member of the Committee on Health Literacy added, “Instead of putting out information in "scientifically" correct ways, we must now recognize that the language of health is filled with jargon that confuses and frustrates Americans of all education levels… In addition, health communicators should always follow tested guidelines about how to effectively communicate with low-literate audiences.”

The potential problems health literacy causes are quite alarming, especially after previous studies have shown a causal connection between failure to understand health information and poor health habits, preventative care, failure to identify and report communicable diseases, increased emergency-room care and hospitalizations.

From an economic perspective low health literacy in turn raises health care costs tremendously- more money is spent on healing patients who are unnecessarily sick and which will further limit the amount of time providers can spend educating patients. Yet more importantly the goal of providing high-quality health services to the public becomes entirely implausible if this roadblock is not lifted.

The American Medical Association has begun to push doctors’ ability to communicate effectively with patients and ensure comprehension; along with their efforts to assist affected populations in several states.

The IOM’s wake-up call must be widely embraced. Not only is patient autonomy at stake but the well being of nearly 90 million people remains in danger- mainly because they were spoken to as if they were the doctors and scientists accountable for medical advice, instead of being those seeking it.

References:

“Study: Low ‘Health Literacy’Widespread” - Associated Press report accessed on April 8, 2004 from CNN.com

http://www.cnn.com/2004/HEALTH/04/08/health.literacy.ap/

“Statement by William Smith, Member IOM Committee on Health Literacy, on the Institute of Medicine Report on Health Literacy”- U.S. Newswire accessed on April 8, 2004

http://releases.usnewswire.com/GetRelease.asp?id=127-04082004

“Health Literacy: A Prescription to End Confusion”- Institute of Medicine of the National Academies accessed on April 8, 2004

http://www.iom.edu/report.asp?id=19723