How many times a day do you imagine patients are given health information on an important topic that they are unable to read or understand? How often are you, as a healthcare provider, confronted with a person looking at you and telling you they can’t read or understand the information at hand?

Over the next few posts, LIFT will take a look at health literacy, its effects on people, and possible solutions to address these issues.

Health literacy is a major issue

88% of US adults are less than proficient in reading, understanding, and acting on medical information.

According to a U.S. Department of Education literacy assessment of more than 19,000 Americans, one in three patients has “basic” or “below basic” health literacy, meaning he or she struggles with tasks such as completing a health insurance application or understanding a short set of instructions about what liquids to avoid drinking before a medical test.

This indicates a tremendous gap in what we are saying and communicating to the American healthcare consumer and what is actually being received, calling into question the value of a great number of healthcare transactions that are conducted every day. Not a good sign at a time when patients are being compelled to be more involved in their own health. “Such a literacy gap has tremendous medical consequences,” explains Robert Chavez, Executive Director, Business Intelligence at University of Miami, Miller School of Medicine in Miami, Florida. “It is widely known that patients with poor literacy skills will have much worse health outcomes than patients who can read well.”

While most healthcare professionals are likely aware of the importance and challenges of health literacy, many more do not understand its scope and importance.

Ask your team if they are aware of these facts:

+ “Nearly 9 out of 10 US adults have difficulty using the everyday health information that is routinely available in our health care facilities, retail outlets, media and communities.” (Kutner et al., 2006)

+ Individuals with low levels of health literacy were more likely to be hospitalized and to experience bad disease outcomes. (Baker et al., 2002)

+ Adults with low health literacy are less likely to comply with prescribed treatment and self-care regimens, make more medication or treatment errors, and lack the skills needed to navigate the healthcare system. (Weiss, 1999)

There is a very high likelihood that your clinical staff understands these facts to some degree…but they are not top of mind. In fact, there is a great likelihood that many on your care delivery team are in the very same boat as those we serve, making the conundrum of health literacy all the more complicated.

Health literacy is not just about reading ability. Patients who have trouble reading or comprehending written information often have difficulty following oral explanations and instructions. And literacy issues can also carry over to numbers—for example, calculating cholesterol and blood sugar levels, measuring medications, understanding nutrition labels, comparing prescription drug coverage that requires calculating premiums, and copays and deductibles all require math skills.

Complicated but doable

Our healthcare system is very complicated. Think about the multinational, multilingual, economically and socially diverse populations that make up most of the larger healthcare markets in America. In order for any form of real transformation in our healthcare system to occur, it is imperative that we as healthcare providers seek to address the unique needs of every patient we serve in a language and in a way that each patient—and family member—uniquely relates to. It’s complicated. But it’s doable if we take a cultural view of how we address patient and user engagement.


Baker DW, Parker RM, Williams MV, Clark WS. Health literacy and the risk of hospital admission. J Gen Intern Med. 1998; 13: 791-798. and Schillinger et al (2002)

Kutner, M., Greenburg, E., Jin, Y., & Paulsen, C. (2006). The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. NCES 2006-483. National Center for Education Statistics.

Weiss, BD, ed. 20 Common Problems in Primary Care. New York: McGraw Hill. 1999: 468-481.

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