Health literacy gap affects care and costs for much of America
April 8, 2004
By Aaron Levin, Science Writer
Health Behavior News Service
Many patients can’t understand a doctor’s discussion of their illness or a pharmacist’s instructions for taking medicine. That might seem like an individual problem, but the additional health expenditure attributable to poor reading skills was $29 billion in 1996. One study of Medicaid patients in Arizona found that costs averaged $7,500 higher among who read at the level of a third-grader or lower, compared to patients who read above that mark.
“A mismatch exists between the reading levels [in health-related materials] and the reading skills of the intended audience,” the report says. “Increasing knowledge, awareness and responsiveness to health literacy both on the part of health services providers and in the community would reduce the problems of limited health literacy.”
While the overall dimensions of the health literacy problem seem clear, many of the details are not. Experts have been unable to sort out the importance of reading inability, limited understanding of health concepts, unfamiliarity with language (either English or medical jargon), or different cultural attitudes toward health and disease.
The problem is so pervasive that only a coordinated effort by patients, doctors, educators and the government must be involved in its solution, say the study authors. For a start, they say, the Department of Health and Human Services should support research into health literacy and set uniform standards to define and measure it.
Further, they add, educators should incorporate more health-related material in curricula at all levels of schooling. Medical, nursing, dental and pharmaceutical schools should also address health literacy in professional training and health care systems should support demonstration programs.
“I know how profoundly the gap between knowledge and practice is widened by limited health literacy,” says the study’s chair, David A. Kindig, M.D., Ph.D., of the University of Wisconsin. “The significance of the problem is too great to wait for complete understanding before we act.”
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