Numbers Tell the Health Literacy Story

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
A doctor explaining to a mom and child.

Many statistics are thrown at us each day, but numbers are often the best way to tell a story. Case in point: a recent article on health literacy in American Family Physician reminds us that more than one-third of US adults lack the ability to understand basic health information provided by their clinicians. In many subgroups, including older adults, the percentage of those unable to understand exceeds 50%.

Sobering figures, indeed. The researchers also point out that while a number of tools exist to screen for limited health literacy, they have not been shown to improve outcomes and are not recommended. Instead, they recommend clinicians use universal health literacy precautions with all patients, regardless of their literacy or education levels.

In an editorial accompanying the main article, Dr. Barry Weiss of the University of Arizona College of Medicine tells the story of a child with strep throat. The mother seemed smart, enthusiastic and involved in her child’s care, relates Weiss, so he was stunned to discover she could not read and had not understood much of the care information she had been given.

In addition to using universal health literacy guidelines, which include avoiding medical jargon, using check boxes, bolding key words and breaking down information into small, concrete steps, the study authors recommend the following:

  1. Prioritize and limit information to three key points for each visit
  2. Use the teach-back method to assess patient comprehension of information
  3. Simplify forms and offer assistance with form completion

The researchers emphasize the importance of using pictures, graphs and other visual aids to enhance patient understanding of written materials. Despite the fact that, on average, US adults read at an eighth-grade level, more than 75% of patient education materials are written at a college or high school reading level. In addition to visuals, the authors recommend writing at or below a fifth- to sixth-grade reading level. A Health Literacy Universal Precautions Toolkit is available at no charge from AHRQ.

As home health executives, you have no doubt seen firsthand the difficulties resulting from limited health literacy, which the report authors say include medication errors, failure to follow through on tests, less use of preventive care and increased hospitalization rates.

Numbers tell the story here, too. An April study in the Journal of the American Heart Association said patients with low health literacy were 34% more likely to have died from acute heart failure than those with higher health literacy after adjusting for insurance status, education and a number of other factors.

Learn more ways to improve patient care and boost patient experience in this blog post.

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