Low Health Literacy Interferes with Good Health Care

Jennifer Wider, M.D.
Society for Women’s Health Research
October 26, 2006

Medical information can be confusing. And most of us can recall having difficulty deciphering health information at one time or another. Whether you have stopped taking a prescription too soon because you didn’t understand the instructions or whether poor vision prevents you from accurately reading the label on the bottle, low health literacy can get in the way of good health care.

Communication problems with health professionals can negatively impact the outcome of medical care for some patients, according to a report by the health literacy committee of the American Medical Association. The report also revealed that inadequate health literacy may increase the risk of hospitalization.

“Health literacy is about communicating health information in ways patients and families can understand,” explains Helen Osborne, M.Ed., president and founder of Health Literacy Consulting, an organization that promotes effective health communication.

An extra burden may fall on women. “Women are the ones advocating for other members of the family, for parents, children, friends or going to the internet to help someone find information,” Osborne said. “Women are very important conduits of health information and need to understand the information because they may be in the role of explaining it to someone else.”

Patients today are expected to play an active role in their own medical care and treatment.  Regardless of age, health status, language barriers and literacy levels, patients have responsibilities that extend beyond the visit to the doctor’s office. Patients need to follow written instructions, understand the benefits and risks of procedures and medications, understand drug-drug interactions and formulate appropriate questions if the material isn’t presented in a clear fashion. It’s a tall order for most people. Unfortunately, many people run into difficulties.

Helen Osborne cites six main reasons for trouble understanding medical information:

• Literacy: if people have trouble reading, they will inevitably have problems with understanding health information.
  
  
• Age: older adults tend to have more problems once the ability to hear and see declines.
  
  
• Disability: any disability that affects the ability to read and communicate may have an impact.
  
  
• Language: non-English speakers tend to run into problems if the instructions are presented in English.  Sometimes, part of the information gets lost in translation.
  
  
• Culture: different cultures may have different understandings and expectations of health care.
  
  
• Emotion: when a person is sick and vulnerable, it can be difficult to fully understand health information.

But clear health communication is a vital part of a patient’s capacity to understand and act upon health information. Patients need to become full partners in their own health care. 

Here are some tips for becoming an active member of your own health care team:

1. Ask questions: even if it feels awkward and don’t be embarrassed if you don’t understand something.

2. Describe symptoms: give a full description of your symptoms: how often, how long, what it feels like, etc.

3. Use Scales: especially for pain, such as ranking the severity of pain from 1-10.

4. Keep personal health records: use a notebook and record your list of medications and test results.  Osborne recommends having a zippered pouch in the notebook for all hospital cards.

5. Enlist a family member or friend: to be your advocate and go with you to your appointments.

6. Overcome communication barriers: bring hearing aids, glasses, or translator if English isn’t your first language.  Let the health professional know if the type is too small on any written material.

If you or someone you know needs basic health literacy information, the Society for Women’s Health Research maintains a Web site called “Her Healthy Life,” which features information for women on diet, exercise and smoking in both English and Spanish. Information can be downloaded at http://www.herhealthylife.org/. Brochures can also be requested by calling toll free 1-877-332-2636 or by emailing info@womenshealthresearch.org.
 

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Sources

Report of the Council of Scientific Affairs: Adhoc Committee on Health Literacy, American Medical Association.  JAMA. 1999;281:552-557.

© October 26, 2006 Society for Women's Health Research