How Patient Health Literacy Impacts Health Care Outcomes

Is this the first health care blog you’ve ever read? Probably not. Many enterprises within the industry post blogs for their target audience, and the aim of these blogs isn’t necessarily to solely sell their services.

So, why are there so many health care blogs on the internet? It’s partially for the purpose of increasing health literacy. Defined by the United States’ Department of Health and Human Services (HHS), health literacy is “the degree to which individuals have the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions.”

High overall literacy in individuals does not necessarily translate to adept health literacy. According to the National Assessment of Adult Literacy, a mere 33% of adults with graduate-level education have proficient health literacy. Note these health literacy facts from Healthy People 2020:

• Adults living below the poverty level have lower health literacy than those living above the poverty level.
• Uninsured individuals and those with public health insurance are at higher risk of having low health literacy.
• When patients receive written health communication materials that don’t match their reading level, patient education is not effective.
• Potential communication barriers between patients and health care providers created by low literacy may lead to a variety of negative health outcomes for the patient.
• Patients with low health literacy tend to use the emergency department more often and are more likely to return to the emergency department after two weeks.  
• Older adult Medicare beneficiaries with low health literacy have higher medical costs, increased ER visits and hospital admissions and decreased access to health care.

Low health literacy is more prevalent among older adults, minority and medically underserved populations, individuals with low socioeconomic status and educational skills and those with limited English proficiency. Factors that impact health literacy include a patient’s receipt of appropriate written health communication materials, ability to accurately interpret written health-related information and communication with providers.

Consequences of low health literacy

In addition to being linked to poor health outcomes, low or inadequate health literacy is correlated with difficulties in comprehension of health information, limited knowledge of diseases and lower medication adherence. These can contribute to poor health, high risk of mortality, insufficient and ineffective use of health care, increased costs and health disparities.

Even for individuals in good health, poor health literacy often means they don’t may not have the skills necessary to prevent disease and adequately manage their health. In adults, there is a direct association between low health literacy and a poor understanding of preventive care information.

As the Centers for Disease Control and Prevention (CDC) notes, even people who read well and are comfortable using numbers can face health literacy issues when they aren’t familiar with medical terms or how their bodies work. Barriers to comprehension include an inability to interpret statistics and evaluate risks and benefits that affect their health and safety, fear or confusion from a serious diagnosis, and overwhelm from health conditions that require complicated self-care. These obstacles become especially challenging when patients are asked to vote on an issue affecting the community’s health while relying on unfamiliar technical information.

As with other health care issues that negatively affect patients, low health literacy adversely impacts the U.S. economy. A report titled “Low Health Literacy: Implications for National Health Policy” estimated the cost of poor health literacy at $106-$238 billion annually, representing 7-17% of all personal health care expenditures.

Recommended measures for health care professionals

Addressing low health literacy is essential to improving the provision of patient-centered care and reducing disparities. One study showed that people who read patient education materials and communicate their understanding back to the doctor are 32% less likely to be hospitalized and 14% less likely to visit the emergency department.

Research shows that clinicians have trouble identifying patients with limited health literacy. Healthy People 2030 highlights six objectives around health literacy, and both the Agency for Healthcare Research and Quality (AHRQ) and the Health Resources and Services Administration (HRSA) offer recommendations on how health care providers can help improve it. A few examples include:

• Assume that all patients and caregivers may have difficulty comprehending health information and communicate in ways that anyone can understand.
• Support patients’ efforts to improve their health.
• Use simple language and short sentences and define technical terms.
• Supplement instruction with appropriate materials.
• Offer assistance with completing forms.

Advanced Care Planning (ACP) Decisions, a non-profit foundation with a mission to empower patients to make informed medical decisions by engaging in shared decision making with their providers, suggests health care professionals utilize technologies that enable more effective communication with patients. These technologies include patient portals, telemedicine solutions, and mobile applications. Whatever type of technology is employed to improve health literacy, however, it should be a tool that potentially impacted populations are able to access. At MLS, our blog aims to educate the patients of our clients- health payers- so all can benefit from a deeper understanding of our health care options and make informed choices to ensure appropriate treatment. Let us know if you’d like us to explore a specific topic in a future blog!