Health illiteracy epidemic can be halted

By: KRISTINE YAHN | Tuesday, December 27, 2005 7:21 PM PST ∞

A silent epidemic affects nearly half of all California adults. The disease is health illiteracy. About 47 percent of adults cannot read complex texts associated with health care decisions, the National Adult Literacy Survey found. Half of those are not able to understand simple label instructions.

Health literacy is defined as "the ability to read, understand and act on health information" by the Council of State Governments.

This is an epidemic that could be remedied in January as part of new legislation to reform California's health care system.

Californians for Patient Care recently briefed legislative authors from both parties. We heard concern and willingness to include literacy in discussions.

Californians pay for health illiteracy in needless consumption of scarce resources and in taxes. Medicaid patients with third-grade or lower reading levels had average annual charges of $10,688, while patients who read above third-grade levels had average charges of $2,891, the Institute of Medicine discovered in a 2004 study.

There is no precise measure of savings, but the potential is dramatic.

There are 3.1 million adult MediCal recipients, according to the most recent state figures. A 2002 Institute of Medicine study estimated that the additional cost was nearly $1,000 per hospital in-patient.

There is a profound impact among your friends and family, according to Institute of Medicine case studies like this: A 2-year-old is diagnosed with an ear infection and prescribed an antibiotic. Her mother understands that her daughter is to take the medicine twice daily. After studying the label at home, and deciding it doesn't tell how to give the medicine, the mother fills a teaspoon and pours the antibiotic into her daughter's painful ear.

Improving health literacy is a shared responsibility. As patients, we are responsible for our health. Ask questions, conduct research, take friends to appointments and listen carefully ---- ask more questions.

As health care professionals, we must create better written and visual materials. We must listen to patients and have dialogues.

Insurers must produce plain English documents and easy access to trained help-desk staff.

Minnesota essentially requires plain English in selected health care documents by mandating that they be written at the seventh-grade level.

Child and adult education curriculum must be coordinated across grades and schools. More health educators would help ---- only 10 percent of health education classes are taught by a teacher who majored in health or physical education, the Institute of Medicine found. Health education texts could be a part of regular literature classes.

Employers can use health literacy in employee training, which could result in lower lost time and insurance premium costs.

Elected officials and regulators must explain the health reform debate in terms that are understood by the voters.

And let's all support health literacy as one small, essential part of the 2006 proposals for California to lead the nation in health care reform. When you read about health legislation in the coming months, let your legislators know that understanding, and being understood, is part of the deal.

Kristine Yahn, president of the nonprofit Californians for Patient Care, is a 37-year nurse who has served patients in Northern and Southern California.

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