Can a commitment to the educational needs of a patient help solve chronic health issues in society? I believe so. According to the American Medical Association, poor health literacy is “a stronger predictor of a person’s health than age, income, employment status, education level, and race.” (JAMA, Feb 10, 1999)
WHAT IS HEALTH LITERACY
Health literacy is the ability to obtain, process and understand basic health information. Problems with health literacy is most common among the elderly, minority groups, low-income population, and the medically under served. Those with poor health literacy are more likely to have a chronic disease and less likely to get the health care needed, even though they have been found to use more health care services. Only 12% of adults have proficient health literacy, according to the National Assessment of Adult Literacy. This means that almost 9 out of 10 adults lack the skills needed to manage their health and prevent disease.
WHY I AM AN ADVOCATE
I’m passionate about engaging patients with poor health literacy because of the struggle I see in those around me. My father, in particular, was a type 2 diabetic with limited education who had difficulty understanding medical information as well as health consequences. He was fortunate to have a daughter with a medical degree to eventually help him understand and make health care decisions. But, what about others who do not have that type of support? For several years, I treated patients at an office in rural Louisiana where a significant percentage of people would be classified as illiterate. A number of elderly patients had no literacy and could only sign an “X” as their signature. Can you imagine their vulnerability to medical errors, fraudulent doctors, and misleading health information? Is it fair to say they are responsible for their health status? Indeed, educating this population group takes some effort. But if we can improve chronic health problems in addition to the economic burden they carry, it is an essential cause.
WHO IS RESPONSIBLE
Everyone plays a role in addressing health literacy. Medical providers, health organizations, and government agencies all must practice in a way to effectively engage the health illiterate patient. In addition, we can all advocate for health literacy within our organizations by sharing literacy resources and circulating relevant research to colleagues. Health literacy information can be obtained from the U.S. Department of Health and Human Services and the Center for Health Care Strategies.
WHAT CAN BE DONE TO HELP
The U.S. Department of Health and Human Services recommends the following strategies to help patients with low health literacy:
- Identify patients with limited literacy levels.
- Use simple language, short sentences and define technical terms.
- Supplement instructions with appropriate materials (videos, models, pictures, etc.).
- Ask patients to explain your instructions (teach back method) or demonstrate the procedure.
- Ask questions that begin with “how” and “what,” rather than closed-ended yes/no questions.
- Organize information so that the most important points stand out and repeat this information.
- Reflect the age, cultural, ethnic and racial diversity of patients.
- For Limited English Proficiency (LEP) patients, provide information in their primary language.
- Improve the physical environment by using lots of universal symbols.
- Offer assistance with completing forms.
The financial impact of poor health literacy is profound. In 2001, an estimated $32 to $58 billion in additional health care cost was attributed to low functional literacy. Health care professional are also subject to legal ramifications if patients to do not understand well enough the information given to them.
A significant part in addressing the low health literate patient is improving communication and understanding cultural diversity. According to the Center for Health Care Strategies Fact Sheet, almost half of the U.S. population will be non-white by 2050. We must take into account cultural attitudes, beliefs and values in order to make health information relevant to each ethnic group.
My desire to help those in need of foot health information, in a patient friendly way, was the basis of starting the blog Foot Scribe. This is one way I am addressing foot health literacy. What about you? What can you do to help?
Foot Scribe 