Low 'Health Literacy' Hazardous to Your Health

FRIDAY July 22, 2011 -- If you have low "health literacy," defined as having difficulty understanding medical information, your health may be at risk.

In a review of 96 published studies, researchers concluded that low health literacy is linked with many types of poorer health outcomes and poorer use of health services.

"There are no real surprises here," said study author Nancy Berkman, senior health policy research analyst at RTI International, a North Carolina-based organization that conducts health research.

The report is published July 19 in the Annals of Internal Medicine, and was funded by the U.S. Agency for Healthcare Research and Quality.

About 80 million Americans have limited health literacy, the researchers report, and that puts their health at risk.

"If you don't understand what is going on, what is being written, this can have a negative impact on your use of health-care services and your health outcomes," Berkman said. "It's imperative you do what you can to understand the communication from the health-care system."

The review found that low health literacy was consistently linked with a number of poor outcomes. These include more hospitalization, a greater use of the emergency room services, less frequent mammogram screenings, less frequent flu vaccinations and a poor ability to take medicines correctly or understand labels and health messages.

Among older people, low health literacy was linked with overall worse health status and higher mortality rates.

They did not find a firm link between poor health literacy and some other health conditions and outcomes. These include access to care, some health behaviors, taking medicine on schedule, severity of asthma, diabetes or high blood pressure control, among others.

The studies also didn't provide firm evidence about one type of health literacy -- a skill called numeracy, which helps people do such things as measure blood glucose and adhere to medicine regimens and outcomes.

While a person's cognitive skills would play a role in how literate they are, the study did not examine this, Berkman said.

The findings came as no surprise to Rima Rudd, a senor lecturer at the Harvard School of Public Health who is the principal investigator for Health Literacy Studies.

While the review is sound, she says, "this offers only half the picture." The problem is not just people's low health literacy, but the inability of some health-care providers to communicate information in a way their patients can understand, Rudd said.

Rudd said patients can demand that health-care provider speak "in every day words." If you don't understand what a health-care provider is telling you, in print or in words, she suggests asking something like this: "I am sorry, but I haven't had your training. Can you use everyday words?"

Ask questions if you don't understand, Berkman added, and don't be shy about asking again and again if necessary. Taking someone with you to the doctor's office can also help, she said.

In an editorial accompanying the study, Cynthia Baur, of the U.S. Centers for Disease Control and Prevention, said the findings reinforce the idea that health communication materials have to be pre-tested with target audiences, among other practices, to be sure they are effective.

More information

To learn more about health literacy, visit the National Network of Libraries of Medicine.

Posted: July 2011


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