The importance of health literacy

 In the United States, African Americans in particular fare worse than the majority population on nearly all measures of health, including infant mortality, life expectancy, cancer, heart disease, stroke, and trauma incidence and mortality; and self-rated health status. Individuals with low levels of educational attainment and income also tend to experience higher rates of illness and death, independent of race.

People of all ages, races, incomes, and education levels can find it difficult to obtain, communicate, process and understand health information and services. Education and literacy rank as key determinants of health, along with income and income distribution, employment, working conditions and the social environment.

 However, this issue continues to cause needless suffering, death, and costs.

While education and literacy are important determinants of health, health literacy as a “silent” form of literacy is becoming increasingly important for social and economic development. Health literacy is defined as: the degree to which individuals have the capacity to obtain, communicate, process and understand the basic health information and services needed to make appropriate health decisions. In other words, health literacy is the ability to make good health decisions every day.

More than 90 million people in the United States – about the same number of people in France, Belgium and the Netherlands combined – have a hard time understanding and using health information. This means that the health of 90 million people in the U.S. may be at risk because of the difficulty some patients experience in understanding and acting upon health information.

A closer look at recent statistics shows that one out of five American adults reads at the 5th grade level or below, and the average American reads at the 8th to 9th grade level, yet most health care materials are written above the 10th grade level.

According to the Center for Health Care Strategies, a disproportionate number of minorities and immigrants are estimated to have literacy problems: 50 percent of Hispanics; 40 percent of Blacks; and 33 percent of Asians. In fact, more than 66 percent of U.S. adults age 60 and over have either inadequate or marginal literacy skills, and 50 percent of welfare recipients read below fifth grade level.

So, imagine what this means in major urban cities around this country where the populations are mostly Brown and Black people.

Never mind that all of these cities have world-class medical centers, hospitals, and the latest in pharmaceuticals and treatments. They mean nothing to people who are disproportionately sicker, poorer, and uneducated. How is it possible for them to benefit? And it’s not just these poor souls who suffer. Low health literacy is an enormous cost burden on the American healthcare system – annual health care costs for individuals with low literacy skills are four times higher than those with higher literacy skills.

Patients with low health literacy and chronic diseases, such as diabetes, asthma, or hypertension, have less knowledge of their disease and its treatment and fewer correct self-management skills than literate patients. Patients with low literacy skills have a 50 percent increased risk of hospitalization, compared with patients who had adequate literacy skills. Only about 50 percent of all patients take medications as directed.

Thirty-seven percent of public school students who start 6th grade will drop out but before graduating, and, according to research from the Kaiser Family Foundation, 34 percent of the city is on Medicaid. For African-American males, that number jumps to 43 percent, and it’s 51 percent for young Latino men.

Individuals with inadequate functional health literacy often struggle with basic tasks when managing a chronic condition such as reading and comprehending prescription bottles, appointment slips, self-management instructions, and educational brochures. Inadequate functional health literacy can be a barrier to controlling disease and can subsequently lead to poor health outcomes and increased health care costs.

So, while we all sit back, comfortably, and watch the dismantling and devaluing of our traditional public school system, consider this: Reading abilities are typically three to five grade levels below the last year of school completed. The average adult in the United States reads at an eighth-grade level yet most patient education materials are written on a high-school or college reading level!

As we continue to go through the motions, trying to figure out how to “fund” and “reform” our public education system, we need to look at what we have become as a society.

Glenn Ellis, is a regular media contributor on Health Equity and Medical Ethics. He is the author of Which Doctor?, and Information is the Best Medicine. Listen to him every Saturday at 9 a.m. (EST) on  www.900amwurd.com, and Sundays at 8:30 a.m. (EST) onwww.wdasfm.com. For more good health information, visit: