Low health literacy: A silent epidemic

What do you call a health situation that:

• Threatens nearly half of the population in the United States, regardless of age, race, education or income level?
• Is estimated to cost billions of dollars a year?
• Can't be detected by physical exam, blood test or any state-of-the-art diagnostic equipment?

Health literacy, as defined by Healthy People 2010, is "the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions." As patients are expected to be more involved in their health care decisions, the ability to comprehend information is critical.

Many people are ashamed to admit that they can't read a pill bottle or write down their next appointment. Often, they don't tell their spouses, let alone their doctors. The 1992 National Adult Literacy Survey concluded 21 percent of the US population reads at or below the 5th grade reading level. An additional 25 percent of the population read at or below the 8th grade reading level.

Four ways to improve health literacy and patient communication

The American Medical Association in its Health Literacy Introductory Kit recommends the following to improve health literacy and patient communication:

1. Improve verbal communication.

• Speak slowly and use simple language.
• Use the teach back technique - ask the patient to repeat in their own words. Say "Tell me what you will do and show me how you will do it."
• Use the chunks and checks technique - provide the patient with only two or three concepts at a time and check for understanding of information through teach back.

2. Modify written language.

• Simplify language, use common words and an active voice.
• Write simple instructions for the patient to take home. Number the steps to be taken.
• Read and review instructions with the patient. Underline or circle key points.
• Use pictures and diagrams to supplement written information.

3. Create a shame-free environment.

• Involve all staff in the effort to simplify and clarify written and oral communication.

4. Use available resources.

• Ask the patient if he or she would like to invite a family member or friend to accompany him or her to the counseling and planning portion of the visit to reinforce health care instructions at home.

Literacy is about the entire process of exchanging health information. Find out more about Health Literacy Month.

If you have any questions pertaining to servicing s with limited English proficiency, sensory impairment and/or low literacy, please contact Provider Services at 1-202-408-2237 or 1-888-656-2383; or Culturally Linguistically Appropriate Services (CLAS) coordinator at 1-202-326-8745.