Illiteracy kills!
By Kristine Yahn, RN, MBA
Executive Director, Californians for Patient Care

Health literacy below a ninth-grade level almost doubles the five-year risk of mortality among elderly people, regardless of education, socioeconomic status, or health, according to a study released a few days ago by UCSF researchers.

This silent epidemic infects nearly half of all adults who cannot read basic texts associated with most healthcare decisions, the National Adult Literacy Survey found. 

The impact is vast: “…low health literacy is linked to lower quality care, poor outcomes and billions of dollars in avoidable costs,” according to the American Medical Association.

Patient literacy begins with medical professionals. Information must be provided in language, both verbal and written, that can be easily understood.

I recently participated in the first National Health Literacy Symposium, sponsored by the Joint Commission on Accreditation of Health Care Organizations, which concluded that “health literacy has gone unnoticed as a public policy issue.”

There are three reasons why Californians must remedy health literacy soon:

1. More consumers are expected to self-direct care.  Nearly 30% of all employers offer some form of self-directed coverage, up from 22% last year.  You cannot direct what you cannot understand.
2. Healthcare cost control reform, a complex issue that affects us all, will be issue #1 in 2007, according to the Governor.  Voters must understand the debate; their lives depend on it.
3. The cost is high. No one knows how many lives are lost, but the estimated annual national cost of low literacy is $29 billion, according to the Institute of Medicine (IOM), or $3.6 billion in California.

Health literacy is defined as “The ability to read, understand and act on health information.”

Conquering illiteracy is a shared responsibility, and Californians for Patient Care, working with our literacy partners, urges immediate action:

• Patients: Take control of health care.  Ask questions, conduct research, take a friend to appointments and listen carefully.  Make notes, keep your own records.

• Health professionals: Produce simpler documents, labels, instructions and even signs.  Use multimedia tools. Ensure understanding by working with patients in developing materials. The state Office of Patient Advocate found that most documents are written for college graduates. A 4th-6th grade level is recommended. And remember to listen – the average physician allows a patient only 22 seconds to speak before interrupting.

• Educators: Include appropriate health literature, like human anatomy, as part of the general public school reading curriculum.  What’s more important than learning how to read with materials that may save your life?

• Employers: Help employees fully understand benefits and treatments – it saves money.

• Community organizations: Promote adult literacy classes. 

Statistics aside, there is the individual trauma inflicted by failure to understand.  Consider this incident reported by the Institutes of Medicine:

A two-year-old is diagnosed with an ear infection and prescribed an antibiotic, which her mother understands that her daughter is to take twice daily.  After carefully studying the label at home, and deciding it doesn’t tell how to give the medicine, the mother fills a teaspoon and pours the antibiotic into her daughter’s painful ear.

Continue to Next Page