Health Literacy: Does It Matter?

Can you read this sentence?  If so, thank your teachers (and our men & women who defend our right to be educated).  But can you actually understand all the drivel that I've been composing the last several months?

I often find myself walking a tightrope trying to decide to whom I am addressing my post, eg my colleagues or my patients (no insult intended - please just realize that there's a lot of specialized terminology in medicine as in most other professions & even hobbies).  In fact, back in January, during our Nevada Academy of Family Physician's Annual Winter Conference, we even had a presentation/lecture on health literacy.

As you know, I've recently taken to answering questions posed on two different websites (I'm sure there're many more).  I've always prided myself on being able to explain medical issues to patients without being condescending, so much so that many patients (and colleagues) have remarked on my use of analogies to communicate and make difficult concepts easier to understand.

So of course I was quite taken aback when the very educated person who posted a question responded, very nicely, that his healthcare background helped him understand the information I gave in my original answer.  This was the second admonishment that I'd received (the first from a 16 year old).  What this means is that my attempt to convey information to a broad range of readers probably failed.  Worse, I'm not sure how much is getting through to the right people.

The reason this is important is that if you can't understand what I'm telling you, how will you understand/remember what to do?  Upon what will you base your decisions?  In a study published last week in JAMA, the authors followed 2,156 patients w/heart failure for over a year and noted that low health literacy was associated with double the all-cause mortality compared to those w/high health literacy (probably in no small part due to the very tricky & complicated pharmaceutical regimen required to medically manage this chronic condition).

It's no surprise that the USA Today is written for a 10 grader (although I've heard reports that lately, its reading difficulty has been lowered down to a 5th grade level).  Most of us can keep our noses clean and avoid having to worry about legal matters (although I doubt too many of you, myself included, really take the time to read the small print & disclaimers, much less understand them).  Various computerized tax applications have simplified the US Tax Code enough for us to complete our own yearly income tax forms (while only a few of us need the skills of an accountant to understand the written intricacies of the IRS).

Unfortunately, health literacy requires a greater reading skill for all of us as very few people can avoid a sporadic visit with their physician, whether for themselves or a loved one.  So if you don't understand what your doctor just said, raise your hand and ask him/her to repeat it in a different way so that you can understand and improve your health.