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Low Reading and Writing Skills May Hurt Your Health

by Jennifer Wider, MD

(Washington DC 10/28/04):  Have you ever left your doctor's office totally confused? Do the instructions on your prescription bottle seem to be written in a foreign language? Do you struggle to understand medical and insurance forms?  If you answer yes to any of these questions, you are not alone. Millions of Americans have difficulty understanding and obtaining the health care they need due to literacy problems.

"Unfortunately, the health of many Americans suffers simply because they do not understand the medical information that is presented to them by doctors, nurses or the media," Sherry Marts, Ph.D., vice president of scientific affairs for the Society for Women's Health Research, said.

Problems reading and understanding health-related information seem to affect older people, non-whites, immigrants and people with low incomes disproportionately.

According to the 1993 National Adult Literacy Study, more than two-thirds of adults over the age of 60 have inadequate literacy skills. Half of all people on welfare read below the fifth grade level; 50 percent of Hispanic Americans and 40 percent of African Americans surveyed have reading problems.

"Health literacy problems are quite widespread," Marts said. "Even among individuals with significant amounts of formal education, there can be problems understanding health issues and medical terminology, which are often complicated and confusing."

Studies have shown a link between poor health literacy and chronic illness. Seventy five percent of adults with a chronic disease (lasting more than 6 months) had deficient literacy skills, according to the literacy study. This group may know less about their illness or how to handle the resulting symptoms than people with adequate literacy skills. One study revealed that diabetics with poor reading and writing skills had more problems controlling their sugar levels than others with better skills.

People with poor literacy skills are also less likely to take care of themselves or get proper care. One study of asthmatics revealed that reading skills strongly correlated with a person's ability to use medications properly. Only a small number of people with poor literacy skills could effectively operate an inhaler, according to the study's results. Another study showed that a significant proportion of people admitted to the emergency department with poor reading and writing skills couldn't understand the forms that they needed to fill out. As a result, they didn't understand their rights and responsibilities as a patient.

"If you, a family member or someone you know struggles with reading or has difficulty understanding personal health care matters, seek help and make sure that the care you receive, including the medications you take, is explained in terms you understand," Marts said. "No one should be embarrassed if they don't understand something a doctor or pharmacist says. You have to be an active participant in the care you receive and that requires you to ask questions and seek clarification whenever needed."

Being part of the health care team and understanding health information is essential for all patients. Now more than ever, patients are expected to play an active role in their own care. Patients are also faced with more direct-to-consumer (DTC) advertisements which often spark more dialogue between the patient and doctor. A Prevention 2000 study found that 54.2 million people spoke to a doctor after seeing a DTC ad. These advertisements promote conversation between patient and doctor and also make the patient more aware of treatment options. This trend further underscores the need for adequate literacy skills among all patient populations.

Here are a few tips to help you or someone you know better understand health information:

  • If you don't speak the same language as your doctor, ask for a translator.
  • If you have any questions, ask them right away.
  • Don't leave the office unless you have full understanding of the advice or instructions given to you.
  • If need be, ask the doctor or nurse to slow down and explain things clearly. Ask if there are any diagrams or pictures available. Some doctors have visual or audio aids available.
  • Take someone with you who can help explain things if you are having trouble.

© October 28, 2004 Society for Women's Health Research

The Society for Women's Health Research is the nation's only not-for-profit organization whose sole mission is to improve the health of women through research. Founded in 1990, the Society brought to national attention the need for the appropriate inclusion of women in major medical research studies and the resulting need for more information about conditions affecting women. The Society advocates increased funding for research on women's health, encourages the study of sex differences that may affect the prevention, diagnosis and treatment of disease, and promotes the inclusion of women in medical research studies. Dr. Donnica Moore has been a member of the Society since 1990 and is a past member of its Board of Directors.

Created: 10/28/2004  -  Donnica Moore, M.D.

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