American Adults Face ‘Health Literacy’ Crisis
By LAURAN NEERGAARD
WASHINGTON (AP) — Nearly half of American adults face higher risks of health problems because of trouble understanding medical terms and directions, experts said Thursday in a report that calls for a national effort to improve health literacy.
Comprehending medicine’s arcane jargon is difficult for even the most educated of laymen. It’s almost impossible for millions who can’t read well, aren’t fluent in English, or have vision or cognitive problems caused by aging.
Now the prestigious Institute of Medicine has put a number on just how many people have “limited health literacy” – a surprising 90 million adults.
They have problems following instructions on drug labels, interpreting hospital consent forms, even understanding a doctor’s diagnosis and instructions.
“It’s a shocking figure,” said Dr. Carolyn Clancy, director of the government’s Agency for Healthcare Research and Quality. Her agency released a second health literacy report Thursday that found there are ways to help, such as with easy-to-read health guides.
The problem of low health literacy is exacerbated by the increasing complexity of the nation’s health care system, contributes to health disparities among the poor and minorities – and may cost billions of dollars, the Institute of Medicine report concludes.
“It’s a public health problem, a societal problem,” said Dr. David Kindig of the University of Wisconsin, who was chairman of the institute’s two-year probe.
Shame and stigma play a big role, the report found. Patients are embarrassed about reading difficulty or worried the doctor will think they’re dumb if they ask questions.
Even the college-educated can have a hard time with examples like this one from the institute: “Patients should be monitored for extraocular CMV infections and retinitis in the opposite eye.” That instruction wasn’t written for doctors – it was on an information sheet for patients.
Another example cited: The mother who poured an oral antibiotic into a 2-year-old’s infected ear, because the prescription label didn’t say to swallow the liquid.
In videotaped sessions with patients, the institute documented worrisome misunderstandings: A mother who misread how much medicine to give her child. A woman who didn’t realize she was signing a consent form for a hysterectomy. A man who thought his doctor considered him “hyper, can’t sit still” because she diagnosed hypertension, the medical term for high blood pressure.
“This goes across all social strata, even people who can read well,” cautioned Dr. John C. Nelson, president-elect of the American Medical Association.
Health literacy isn’t a new problem. Surgeon General Richard Carmona has made the issue his cornerstone; the AMA has long sponsored efforts to improve doctors’ communication; and pilot programs to help Medicaid patients or people in adult reading classes better understand health instructions are under way in several states.
But if doctors actually quizzed patients about what they understood after a visit, they’d be stunned, said Dr. Harvey Fineberg, president of the Institute of Medicine, which advises the nation on health.
Numerous studies show patients with limited health literacy are more likely to need hospital care, have poorer health habits and are less likely to use preventive services. That in turn increases costs. One study found hospital spending is $993 higher, on average, for a patient with inadequate health literacy.
Among the report’s recommendations:
– The government should pay for research on ways to improve health literacy.
– Accrediting organizations should require that schools follow national health education standards, from elementary school through college.
– Health organizations and medical schools should teach health literacy and how to communicate with patients.
– Medicare, insurers and other health groups should develop creative ways to communicate clear health information.
—–
On the Net:
More science, space, and technology from RedNova
Copyright 2004 Associated Press. All right reserved. This material may not be published, broadcast, rewritten, or redistributed.