Health Literacy

A Summary for Respiratory Care Students

The Problem—our side

• Our health care education,– Varied, for some, as much as 20 years

• Common talk is filled is jargon and acronyms—COPD, CVA, CABG, etc.

• Technological advances—ventilators, IV pumps, monitoring equipment, etc.

• Proliferation of tests

The Problem-the patients’ side

• Approx. 90 million Americans or about half the population has trouble or difficulty using and understanding medical and health care information

• “health literacy”--Obtain, process and understand information to make decisions about health care

Literacy and Health

• Poorer overall health

• Less likely to make use of screening

• Present in later stages of disease

• More likely to be hospitalized

• Poorer understanding of treatment

• Less likely to stick to medical regimens

Why at Risk?

• Patient instruction is based on written words

• Health care system is now more complex– More medications (e.g., asthma medications)– More tests and procedures– More specialists– More emphasis on self-care

Poor Reading Skills Correlatewith Less Knowledge of Asthma

• Best predictor of health status

• Better than– employment status– Age– Income– Racial or ethnic group– Education level

Levels of Illiteracy

• Level 1– Can sign name

– Cannot read bus schedule– Cannot enter information on a government

application

• Level 2– Can find location on a map, e.g., intersection

of two streets– Can determine difference on price on tickets

– Cannot read bus schedule consistently– Cannot identify information on a bar graph– Cannot write a letter of complaint

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Major Problems

• Medications

• Appointments

• Informed consents

• Discharge instructions

• Health education materials

• Insurance applications and forms

Changes in System

35 yrs ago Today

Acute MI Tx 4-6 wks rest 2-4 days

Available Rx drugs 65010,000+

Aging and Literacy

• 44% had inadequate literacy levels

• Were not able to understand:– Take medications q 6 hours 48%– Identify next appointment 27%– Take on an empty stomach 54%

What Works?

• Teach back

• Shame free

• Use common words

• Simple, specific, direct sentences

• Sequence ideas clearly and logically

• Attentive to culture

• Attentive to age, especially seniors

• Therapeutic Communication