Health Literacy

Question 1

What is health literacy - example

Answer 1

• “I can’t pronounce the names of my pills. I ask for them by their shape, size, and color”.

Question 2

Health literacy gap

Answer 2

people’s skills -> health literacy <- health systems complexity

Question 3

medication instruction errors - study

Answer 3

• study of 395 primary care patients in 3 states asked, “how would you take this medicine?”
• 46% did not understand the instructions on more than one label
• 38% with adequate literacy missed at least one label

Question 4

Reading vs comprehension - study

Answer 4

• study of adults with literacy below the 6th grade level
• 71% correctly read the instructions, “take two tablets by mouth daily”
• only 35% could demonstrate the number of pills to actually take

Question 5

Dosing instructions

Answer 5

Lots of ways to get it wrong
- abbreviations
- uncommon measurements
- unfamiliar terms
- inconsistent markings

Question 6

Assuming you knew what something meant - study

Answer 6

• study of physician and patient communications
• most physicians (77%) believed patients knew their diagnosis, however, 57% of patients actually did
• nearly all physicians (98%) stated that they at least sometimes discussed their patients’ fears and anxieties, compared with 54% of patients who said their physicians never did this

Question 7

Health Literacy definition

Answer 7

• ability to obtain, read, understand, and use health information and services (CDC, 2023)

Question 8

Wide range of skills needed to help people understand and use information to lead a health life

Answer 8

• understand appointment notices
• following instructions on medication labels
• get information about illness
• participate in discussion of informed consent
• making appropriate medical decisions

Question 9

Health Literacy in the public examples

Answer 9

• voting on smoking ordinances
• vaccinations
• emergency preparedness
• wearing a helmet
• causes of diabetes
• OSHA workplace regulations

Question 10

Percentages of proficiency of health literacy in America

Answer 10

Proficient (12%)
- define medical terms, calculate share of employee’s health insurance costs

Intermediate (53%)
- determine health weight from BMI chart, interpret prescription and OTC drug labels

Basic (22%)
- understand simple patient education handout

Below Basic (13%)
- circle date on appointment slip, understand simple pamphlet about pre-test instructions

Question 11

Overall health literacy in the US

Answer 11

• 90 million Americans have difficulty understanding and using health information - over 40 million additional people can’t read complex text
• about 1.6 million Missourians have basic or below basic health literacy

Question 12

Impact of poor health literacy

Answer 12

• less likely to comply with treatment and medication plans
• less use of preventative services - immunization, physicals, screenings
• risk of hospitalizations and longer stays
• not managing chronic conditions properly
• increased costs and poor health outcomes
• increased mortality

Question 13

Patient recall of health information

Answer 13

• forget 40%-50% of what their provider tells them as soon as they leave the office
• nearly 50% of what they do remember is wrong
• the more information a patient is given, the less they recall

Question 14

cost of health care for those with low literacy

Answer 14

• those with low health literacy have over 4X higher annual health care cost
• $13,000 avg annual cost for those with low health literacy
• $3,000 for those with a higher health literacy

Question 15

yearly costs of poor health literacy (economic)

Answer 15

• 3.3 to 7 million dollars a year in MO
• 238 billion dollars a year in the US
• Human costs: increased pain and suffering mental health, lost work and leisure time

Question 16

Who pays for low health literacy %

Answer 16

• 47% Medicaid
• 19% Medicare
• 14% employers
• 14% patients
• 6% other

Question 17

Health literacy affects health outcomes

Answer 17

• literacy -> [health contexts <- health literacy -> individuals] -> health outcomes and costs

Quality of life is affected by:
- later diagnosis of disease and aliments
- poor medication and treatment adherence
- less preventative care utilization
- increased need for chronic care measures
- greater costs for person and system

Question 18

Universal precautions meaning

Answer 18

• communication strategy that assumes all healthcare encounters are at risk for communication errors and aims to minimize risk

Question 19

Why health literacy now?

Answer 19

Most patient instructions are:
- complex
- delivered rapidly
- easy to forget under stress

Healthcare is increasingly complex
- more medications, tests, and procedures
- more self-care requirements
- more individual input into decisions

Understand how patients’ background affects their decision making

Question 20

Aspects affecting health literacy

Answer 20

• culture
• religion
• health disparities
• compliance rates
• education level

Question 21

Universal precautions to take

Answer 21

• strive to make visits consumer-centered
• explain things clearly in plain language
• focus on key message and repeat
• use the “teach back” or “show me” method for understanding
• use consumer-friendly education material to enhance interactions
• use medical interpretation services

Question 22

How to explain in common language

Answer 22

• most patients don’t understand anatomy
• words are used differently in healthcare
• try to use patient’s own words
• common language
• use analogies that are relatable to the patient

Question 23

Visuals can help understanding

Answer 23

• consumer-friendly pictures of demonstrations are often helpful to low literacy patients
• health drawing provided to MDs by companies are often complicated

Question 24

Talking with family

Answer 24

• use plain language
• slow down
• break it down into shorter statements
• focus on 2-3 most important concepts
• check for understanding