Warren Buffet once said “Risk comes from not knowing what you are doing.” Buffet is an investor and business tycoon and likely referring to the risk associated with business ventures; however, this sentiment is true when talking about health knowledge. Business risks are unlikely to kill you, but lacking understanding of matters that affect your health can be fatal.
The Patient Protection and Affordable Care Act of 2010, Title V, defines health literacy as the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions (Center for Disease Control and Prevention, 2019). We all need to take steps to improve our own health literacy, that of our loved ones and that of the population as a whole.
Individuals with low health literacy may have difficulty locating providers and services, filling out complex health forms, sharing their medical history with providers, seeking preventive health care, knowing the connection between risky behaviors and health, managing chronic health conditions and understanding directions on medicine. (Health Resources & Services Administration).
Nearly 36 percent of adults in the U.S. have low health literacy, with a higher number among lower-income Americans eligible for Medicaid. This may appear to be a problem for only the individuals affected, but everyone should care about health literacy. Low health literacy has a large economic impact – those with low health literacy experience greater health care use and costs compared to those with proficient health literacy.
In 2018 the U.S. spent $3.6 trillion or $11,172 per person on healthcare. The estimated cost of low health literacy to the U.S. economy is between $106 billion to $238 billion annually.
So, what can we do to improve health literacy? It is first important to recognize health literacy as a systems issue, which reflects how complex the presentation of health information is as well as how difficult the healthcare system can be to understand.
The educational system can prepare students at all levels to be competent consumers of healthcare. This will benefit the students in the future, and it can also benefit their parents or grandparents who may have low levels of health literacy. Providing students with trusted sources of information will empower them to make knowledgeable healthcare decisions.
Funding should be allocated for adult education about the healthcare system and materials developed about preventative health for all reading levels. Some educational materials are currently available, but an assessment of health literacy and the dispersing of materials based on level will be more effective.
The healthcare system should increase the availability and use of nurse navigators, especially for patients with very low levels of health literacy. Nurse navigators advocate for patients by helping translate complex medical information into language they can understand and apply, and make the overwhelming more manageable.
I urge you to evaluate your own level of health literacy by asking yourself if you really know what your healthcare providers instructions mean. If you don’t you should not be afraid to tell them or ask for a simplified explanation. Do you know what you should be eating and how much exercise you should be getting to maintain or improve your health? At your next check-up be prepared with a list of questions and advocate for yourself and for your health.
Ask your primary healthcare provider how they assess health literacy levels in their patients and if they have educational materials at different reading levels. If they don’t perform an assessment or only provide educational materials that require a high level of health literacy ask them to adopt a health literacy assessment tool for their office and to request additional educational materials.
You should also evaluate the health literacy of your loved ones, especially if they are elderly. Are they taking their medications correctly, adhering to their ordered diet and getting enough exercise? If you have children you should engage them in conversations about health promotion and disease prevention. Ask them what health topics they are learning about in school. If it seems inadequate, have a conversation with the principal or attend a school board meeting to discuss expanding or developing the health curriculum and improving the health literacy of the students.
If you are feeling extremely motivated to make a change, contact national legislators to advocate for funding that will help employ nurse navigators in underserved areas. In your letter you can also advocate for funding for the creation and advertising of free programs lead by multilingual health professionals that cover topics such as the management of common diseases and conditions, how to prepare for a visit to a healthcare provider, what questions to ask your healthcare provider, finding trusted sources of health information and how to properly read prescriptions and take medications.
All of these actions will be a step in the right direction towards improving health literacy. Investing time and money into improving health literacy has the power to create a healthier population and decrease the amount of money that is spent on healthcare. Health literacy affects us all and improving it is a responsibility that we all share.
Mary Nketia lives in Storrs.