The High Cost of Low Health Literacy: What We Can Do

The majority of American adults are either functionally illiterate or substantially limited in their ability to meet the demands of everyday life, according to the National Adult Literacy Survey conducted in 2000. In California, about 1 in 4 adults function at the lowest levels of literacy.

Literacy has an especially important impact when it comes to health care. While people with poor reading skills may have developed coping mechanisms that work in everyday settings, these mechanisms may not work in a health care setting, especially in an emergency.

People of any age, income, race, or background can find it difficult to understand health information. In fact, the health of over 90 million people in the United States may be at risk because of the difficulty they experience in understanding and acting on health information.

It behooves health care professionals, legislators, and health care fundors, indeed the whole society, to address this important reality.

Health literacy is all about communication.

Health literacy can be defined in two ways:

• An individual’s ability to read, understand, and use health care information.
• A health care provider’s ability to explain, write, and share health care information so that their clients can truly understand and get the health care they need.

Clear communication is the basis of good health care. When an individual reads and understand information at a 4th grade level and a health care provider can only explain things at a college level, there is clearly a mismatch in communication.

This mismatch is also mirrored in the health education materials given to clients, which are often written at the 10th grade level or higher. When it comes to comprehending the difficult concepts needed to navigate a complex health care system, this mismatch is even more dramatic.

The cost of low health literacy is high.

A limited ability to read and understand health care information translates into poor health outcomes and higher economic costs – with estimates between $50 to $73 billion every year. This is largely due to medication errors, excess hospitalizations, longer hospital stays, and a greater use of emergency room.

In one study, it was found that the average annual costs for all Medicaid enrollees were $3000 per enrollee. For enrollees with limited literacy skills, the average annual cost per enrollee skyrocketed to $13,000.

Research has shown that literacy is the single best predictor of health status, outweighing all other demographic and sociological indices. People who do not read well:

• Make more medication or treatment errors.
• Are less able to follow treatments.
• Don’t have the skills they need to get the health care they need.
• Have a higher chance of hospitalization than people with adequate literacy skills.

And there is a cost to self-esteem. People with low literacy skills often feel less able to take care of themselves and their families.

They are less likely to ask questions and feel that they have a part in decision-making. They may not come for needed care, simply because they dread filling out the forms.

So what can health care professionals do about low health literacy?

We can:

• Support and fund adult literacy programs in our communities.
• Research and fund better ways to communicate health care concepts with all clients, especially those with low literacy skills.
• Make our health care practices more client-friendly.
• Find ways to avoid breakdowns in communication that lead to confusion and poor health outcomes.
• Create or choose easy-to-read written materials to help clients recall needed health information.

Need more information about health literacy?

Need help with making your health care practice more client-friendly? Want to learn more about creating or choosing easy-to-read written materials? Call our toll-free number 1-800-428-5438 to find out more.