Health Literacy

Health Literacy Defined According to Healthy People 2010 health literacy is defined 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." (To read to entirety of Healthy People 2010 please visit [1])

Health literacy includes a variety of topics including, navigating health care systems, understanding your health insurance, knowing how to locate important health information, understanding your prescription drugs, understanding appointments slips and consent forms, and much more. In general, the average person in the United States is not competent in one or more of these areas. According to the Institute of Medicine, in 1999 there were nearly 90 million Americans who had trouble locating and using health information.

Populations at Risk According to the National Assessment of Adult Literacy in 2003, the population at most risk of being illiterate in health information are those who have between 0 and 8 years of education. Ninety-six percent of this population proved not to be health literate. Eighty-one percent of citizens over 65 were not health literate. The National Adult Literacy Survey, also completed in 2003 shows that seventy-eight percent of those that are not health literate, were unemployed at the time, and seventy-one percent of them were male. Almost twenty-four percent of the subjects surveyed had reading levels that were below third grade. (It is important to keep in mind that this survey targets populations that tend to have poor health literacy and it is not necessarily representative of the entire population.)

Cost of being Health Illiterate A study done by the National Academy on Aging Society estimated the costs at about $73 billion in 1998. The 2003 Assessment of Adult Literacy suggests that this lack of health literacy costs $106-238 billion a year. The National Adult Literacy Survey mentioned earlier shows that those subjects with a reading level above fourth grade spent an average of $2890 in health care costs, while subjects with a reading level at or below third grade spent an average of $10,688 a year. (That’s over $7000 more per year!) Some reasons for this expense are that on average, patients with low health literacy stay in the hospital more often, and for longer periods of time. To put these numbers in perspective, the government has estimated that it would cost around $200 billion a year to cover all of the uninsured people in the United States, and low health literacy costs between $106-238 billion a year.

Factors Contributing to Poor Health Literacy There are a number of factors that could lead to someone having poor health literacy. A few contributing factors are physicians using terminology that patients cannot understand or misunderstand, having low education skills, cultural differences, language barriers, and complexity of health care systems. The American Medical Association says that health literacy is “a stronger predictor of a person's health than age, income, employment status, education level, and race”

Misunderstanding health information – Many people have trouble understanding their health information because of the way that it is delivered by their health care professionals. Many physicians use terminology that is too complex for the average person to understand. Also, many physicians do not take the time to completely explain medication instructions, consent forms, insurance forms, applications, and a variety of other paperwork. Also, people do not take the time to ask questions and give their care providers an opportunity to explain.

Having low education skills – The reading level of the average American is 4th grade and most health information is published at the 8th grade level. This simple fact discourages a lot of people from even attempting to read health information on their own. Also, spending less time in the classroom and less time being taught about health topics, people are not as apt to research health issue are their own.

Cultural differences and language barriers – A health care professional not being trained in cultural differences could cause problems in health literacy. An example would be if a health care professional was not aware that it was a sign of respect to Asian-Americans to not make eye contact with them, but it is a sign of respect to black Americans. This could cause conflict because if a patient or client feels disrespected they are less likely to listen or ask questions about information they don’t understand. Language barriers cause problems in health literacy simply because there is a lack of translators in health care settings and the majority of health care professionals are not bilingual.

Complexity of Health Care Systems - The health care systems in the United States are made more complex when people do not understand how to navigate through them. Common barriers that people are stopped by include: evaluating physicians, evaluating hospitals, communicating with physicians, understanding Medicare and Medicaid, obtaining and understanding insurance, accessing information about a diagnosis, making a plan for the end of life, and privacy rights.

Bauman, D. (2007). New report estimates cost of low health literacy between $106-238 billion annually. Retrieved February 03, 2009 from National Patient Safety Foundation: http://www.npsf.org/pr/pressrel/2007-10-11.php.

Carmona, Vice Admiral R. H.,M.D.,M.P.H,FACS. (2003). American Medical Association House of Delegates meeting: Health literacy in America: The role of health care professionals. Retrieved February 02, 2009 from U.S. Department of Health and Human Services, Office of the Surgeon General: http://www.surgeongeneral.gov/news/speeches/ama061403.htm.

Glassman, P. (2008). Health literacy. Retrieved February 02, 2009 from National Network of Libraries of Medicine: http://nnlm.gov/outreach/consumer/hlthlit.html.

Health Literacy. (2008). Retrieved February 03, 2009 from U.S. Department of Health and Human Services: Health Resources and Services Administration: http://www.hrsa.gov/healthliteracy/.

Health literacy and older adults. (2008). Retrieved February 02, 2009 from U.S. Department of Health and Human Services: http://www.health.gov/communication/literacy/olderadults/literacy.htm#p5.

Potter, L. (2005). Health literacy fact sheets. Retrieved February 03, 2009 from Center for Health Care Strategies, Inc., Family Health Research: http://www.chcs.org/publications3960/publications_show.htm?doc_id=291711.

Quick guide to health literacy: Fact sheet. (2003). Retrieved February 03, 2009 from U.S. Department of Health and Human Services, Health Literacy Basics: http://www.health.gov/communication/literacy/quickguide/factsbasic.htm.

Statistics at a glance. (2008). Retrieved February 04, 2009 from Pfizer, Clear Health Communication Initiative: http://www.clearhealthcommunication.com/media/stats-at-a-glance2.html.

http://www.coverageforall.org/pdf/BC-BS_Uninsured-America.pdf Article explaining that a segment of the uninsured in America are eligible for government healthcare, but dont know it