Health literacy is becoming a Georgia priority — though there’s still plenty of room for improvement.
The state’s schools of medicine, nursing, public health, dentistry, pharmacy and education, as well as community organizations, are all working on improving people’s ability to understand health information so they can make good decisions about their medical care.
An estimated one in six adults in Georgia do not have sufficient health literacy.
In a Pharmacy and Therapeutics journal interview, Dr. Ruth Parker of Emory University said that “many people can’t read and understand and act on a medicine label, so we’ve started thinking: ‘What is it that we’re asking them to do, and [then asking] how good a job are we doing?’ ”
Poor health literacy among the public is the kind of weak link that can undermine even the best health care system.
Laura Hauser of DeKalb Public Library’s Literacy Services says, “We cannot assume that most people today fully grasp what health care professionals are trying to convey when giving directions and explaining medications or medical procedures.”
Health literacy is a particularly low among the poor and uneducated. But it is not simply an issue of reading ability, nor is it necessarily based on a person’s IQ. Research shows there are people from all ages and backgrounds — and all income and education levels — who run into problems because they’re unable to understand their own medical information.
The consequences can be very serious. When hospitals have to readmit patients they’ve already discharged, it’s often because poor communication caused patients to not maintain the proper care once they got home.
According to the American Medical Association, “individuals with limited health literacy incur medical expenses that are up to four times greater than patients with adequate literacy skills.”
The economic burden of poor health literacy is estimated at $106 billion to $240 billion per year in the United States. It’s far too high a price to pay in terms of dollars, but more importantly, the human toll is staggering.
The reasons behind the rules
Take a fictional patient, Jack.
Jack’s prescription says: “Take one pill twice a day.” But he works nights, and his schedule is harried. So he swallows both pills at night to avoid taking the second one in the morning, when he may be tired and forget. That short cut may seem more convenient than following the directions exactly, but it’s a bad idea.
For many medications (such as digoxin), it’s important to maintain a certain level of the drug in the bloodstream around the clock. Otherwise the medicine may not work properly. So ignoring the instructions and taking the whole daily dosage at once is counterproductive and even unsafe.
No one explained that to Jack, or it wasn’t explained clearly. His lack of knowledge may make him the next medical emergency.
Even though he didn’t understand its importance, the language of Jack’s prescription was clear. But in some medical situations, patients are confronted by terminology they simply don’t grasp. And nowadays many Georgia residents are not native speakers of English.
Georgia has well-documented health disparities and high rates of chronic medical conditions that can be exacerbated by an inability to understand directions.
“We all are working on messages that tell people what they need to do, where to get help, and empower them to ask questions — and then deliver these messages at the point of care,” explains Kara Tarantino, director of marketing at Georgia-based Vericom Corporation, a company that focuses on health messaging. “People need information that’s easy to act on.”
Health care instructions can be tough to understand. But the rules and provisions of health insurance can be downright bewildering. And things may get worse, at least for a while, once the federal Affordable Care Act is fully implemented in January.
Attention to the readability of health documents and medication labels is critical.
“Readability is of immense importance, but so is the clarity of face-to-face interaction,” says Don Rubin, professor emeritus with the University of Georgia’s Center for Health and Risk Communication. “The trick is never to lose sight of all communication needs, even amidst all the complexity and crises of medicine.”
Research shows that patients who take part in their own health care decisions are more likely to get better faster.
Patients should speak up and say, “I don’t understand,” if the information is too complicated or is explained in terms that are meaningless to them. Every person should have the ability to receive, think about, and understand the treatment and care they will be receiving, experts say.
Judi Kanne, a registered nurse and freelance writer, combines her nursing and journalism backgrounds to write about public health. She lives in Atlanta.