Case for Change

Communication is the backbone of health care delivery. Patients offer their symptoms, concerns, and medical histories. In return, providers discuss ailments and illnesses while describing solutions and treatments. The success of a treatment hinges largely on the communication between the patient and the provider. Unfortunately, this can be an obstacle for many patients.

Millions of U.S. adults possess literacy skills below-high school levels. Twenty percent of U.S. adults read at or below the fifth grade level. Iowa literacy rates are also low, with 38 percent of adults reading at below-high school levels. While individuals with low literacy levels may struggle with many areas of their life, the problem is particularly germane to health care. In this context, it is referred to as “health literacy.” Health literacy 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.”

Patients with low health literacy have difficulty accessing the medical world, a world filled with jargon, acronyms, and arcane language. This limited understanding can manifest itself in numerous ways. Patients may:

• have difficulty understanding their disease, their treatment, or their medications.
• fear asking their provider questions.
• feel unintelligent or ignorant when it comes to their treatment.
• misunderstand their illness or treatment and therefore endanger their health.
• avoid seeking further medical assistance.

Health care professionals cannot increase the literacy rates of their patients. Instead, providers must acknowledge these low health literacy rates and alter their delivery of care accordingly. This step toward improving health literacy focuses on the following areas:

• Improving interpersonal communication between providers and patients.
• Using tools to guarantee a patient’s comprehension of health information.
• Simplifying health care situations such as check-in or health care referrals.
• Developing simpler paperwork and educational materials.
• Empowering the patient to ask questions.

Iowa providers need to consider the health literacy level of their patients, acknowledge health literacy deficits, and dedicate efforts to improve health communication. Providers will thereby improve health outcomes, save resources, and improve the quality of care.

Sources:

• Health Literacy: A Prescription to End Confusion. Nielsen-Bohlman L, et al. (eds). National Academies Press, 2004.
• Iowa Health System Rural Health Literacy Collaborative. Learning Session Materials, June 18, 2006.
• Office of Disease Prevention and Health Promotion. Healthy People 2010 Last viewed August 2006.
• "Synthetic Estimates of Adult Literacy Proficiency." Stephen Reder. Portland State University. Last viewed August, 2006.