Health Literacy

The Agency for Healthcare Research and Quality puts out a number of outstanding reports summarizing the evidence around key health issues.  A recent one updates a 2004 report on health literacy.   (AHRQ Report) Health literacy refers to the ability of consumers to assimilate information about their health status, diseases, and treatment options and to make decisions based on that information.  Estimates are that more than a third of the population has fairly limited health literacy.  The report assessed both written and oral literacy and the ability to understand numbers.  It also evaluated various interventions to improve literacy.

As might be expected, the review of the published studies confirmed that low levels of health literacy are correlated with poorer health and worse health outcomes.  Some of this is as basic as patients not being able to read drug labels so that they can take their medicine properly.  Most interventions appeared to have a positive effect on health literacy and on outcomes.   The best interventions focused on skill-building, were pilot-tested and were delivered by a health professional.  Improving health literacy appears to also have the potential to reduce costs by lowering hospitalizations and emergency room use.

It should be noted that this country has a shockingly high general rate of illiteracy.  In many large urban areas, less than 50% of students even get a high school degree.  These poorly educated persons tend to be poorer and in worse health.  In addition, many elderly persons with cognitive deficits also contribute heavily to health spending.  So those who are incurring more cost are probably least capable of acting as informed consumers.   The Journal of the American Medical Association has a recent article about the importance of physicians identifying patients with limited health literacy.   (JAMA Article) The presence of many patients with health literacy issues means a variety of methods need to be employed to ensure that patients actually understand their health problems and can participate in making informed decisions.