Low Health Literacy: A Silent Epidemic

What do you call a health situation that:

  • Threatens nearly half of the population in the U.S., regardless of age, race, education or income level?
  • Is estimated to cost billions of dollars a year?
  • Can't be detected by physical exam, blood test or any state-of-the-art diagnostic equipment?

Health Literacy, as defined by the Healthy People 2010, is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." However as patients are expected to be more involved in their health care decisions, the ability to comprehend information is critical.

Most people are ashamed to admit that they can't do such simple things as read a pill bottle, or write down their next appointment. Often they don't tell their spouses, let alone their doctors. The 1992 National Adult Literacy Survey concluded 21% of the US population reads at or below the 5th grade reading level (functionally illiterate). An additional 25% of the population read at or below the 8th grade reading level (marginally literate). The American Medical Association in its Health Literacy Introductory Kit recommends "Four Simple Ways To Improve Health Literacy And Patient Communication."

  1. Improve Verbal Communication.
    • Speak slowly and use simple language.
    • Use the teach back technique - ask the patient to repeat in their own words. Say "Tell me what you will do and show me how you will do it…"
    • Use chunks and checks technique - provide the patient with only two or three concepts at a time and check for understanding of information through teach back.
  2. Modify Written Language.
    • Simplify language, use common words and an active voice.
    • Write simple instructions for the patient to take home. Number the steps to be taken.
    • Read and review instructions with the patient. Underline or circle key points.
    • Use pictures and diagrams to supplement written information. 
  3. Create a Shame-Free Environment.
    • Involve all staff in the effort to simplify and clarify written and oral communication.
  4. Use Available Resources.
    • Ask the patient if he or she would like to invite a family Participant or friend to accompany him/her to the counseling and planning portion of the visit to reinforce health care instructions at home.

Literacy is about the entire process of exchanging health information. Visit Health Literacy Month for more information on health literacy.

If you have any questions pertaining to servicing Participants with limited English proficiency, sensory impairment, and/or low literacy, please contact our Participant Services Department at 1-855-235-5115.

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