Health Literacy: A Provider Problem, Too

News

Health literacy is a global problem. Nine out of 10 adults have trouble applying the health information they see in the media or get from healthcare facilities to their own lives. 

Defined as how well a person can find and understand the information they need, health literacy affects every decision we make about our health, from choosing a doctor to buying cough medicine.

That is why providers and organizations, like the CDC and National Institutes of Health (NIH), want to improve the way the healthcare system delivers information and advice. Low health literacy impacts surgery outcomes, medication dosages and more.

The problem

Low health literacy affects all aspects of healthcare, said Terry Davis, PhD, a professor at Louisiana State University Health Sciences Center, who has studied health literacy for 3 ½ decades.

The problem goes as far as “figuring out how much medicine to take, particularly children’s dosing, because it involves solving math problems — anything involving probability, graphs or statistics, even food labels,” said Dr. Davis in an interview with Medical Daily ,

According to research on disease prevention funded by the NIH, people with relatively low health literacy tended to skip preventive care. They visit the emergency department more often and are admitted to the hospital more often than those with higher health literacy. They may not understand how to manage their chronic conditions, take their medicines correctly or understand hospital discharge instructions, said Dr. Davis. 

A recent University of Alabama at Birmingham study found that health literacy may affect infection rates after surgery. Researchers looked at the medical records of 270 people who had bowel surgery, according to this video abstract. Prior to bowel surgery, the patient is asked to drink a special liquid, called a bowel prep, to clear the bowel. In a press release, the researchers said if the patient did not understand the bowel prep instructions and it was not done correctly, any stool left in the colon could infect the surgical wound, possibly causing an infection. The study found that patients with low health literacy had 4 ½ times greater odds of developing an infection after bowel surgery, compared to patients who had higher health literacy. 

“It’s important to understand that patients with limited health literacy might be at higher risk for an infection after surgery, so we can start to understand why and design interventions and tools to better support those patients,” said lead investigator Lauren Theiss, MD, in a press release from the American College of Surgeons.  

“But the burden should not be on the patient. As providers, we should interact with patients assuming they have limited health literacy. It’s our responsibility to engage patients and make sure they understand what’s being communicated to them,” she said.

Dr. Theiss said healthcare providers need to change how they educate people about their health. She recommended providers, including physicians and surgeons, use pictures, speak slowly, use plain language and ask the person to repeat back any instructions in their own words. In this case, she said, a series of pictures could help a surgical patient do the prep correctly, to reduce the risk of infection.

Nurses may be the best people to educate people with low health literacy, said Dr. Davis. “Part of their training and mission is education. We give them training in communication and patient education. [On the other hand], doctors are trained to diagnose and treat.” 

The take home

Providers are working to improve the way they present health information. If a healthcare provider gives you information that you don’t understand, ask for a simpler explanation, including pictures and written information to take home. And then repeat their instructions back to them in your own words. Teaching someone else is the best way to learn. 

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