More than 80% of health information provided in a doctor’s office is forgotten before patients or parents get home. More than half of the recalled information is remembered incorrectly.1,2
While fully aware of the role of health literacy-related problems in patient care and the importance of good communication skills, pediatricians often struggle with and underutilize specific techniques to improve communication.3 Pediatricians should be aware of what health literacy is, how it might impact their practice, and steps they can take to improve health literacy in patients and their families.
What is health literacy?
In Health Literacy: A Prescription to End Confusion, the Institute of Medicine defines health literacy as ‘‘the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”4 Just because a person is able to function at home or work does not mean that they will have adequate literacy in the healthcare setting.
Health literacy is complex and encompasses a number of skills and abilities for patients to be successful. This can be challenging as it includes several different tasks, such as:4
· Navigation: The ability to locate a provider or prescribed ancillary services as well as filling out the required forms to get the service.
· Communication: The ability to share personal health information with a provider who needs it to provide care.
· Managing chronic disease: The ability to act on provided health information for chronic disease management. This could include skills that require patients to understand a wide range of information visually, operate a computer to obtain information, or the ability to obtain and then apply information.
· Numeracy: Being able to measure and appropriately deliver a liquid medication to a child as well as comparing different health plan information. Patients and parents often need to be able to analyze relative risks and benefits if they are going to fully participate in their care.
Although the pediatrician may not be able to address a number of the societal issues and causes of poor health literacy in his or her own practice, the pediatrician can ensure the practice is health-literacy friendly so that patients and parents can fully engage in care that is needed.
How health literacy impacts patients
Patients with poor health literacy are less likely to participate in preventive care activities such as flu shots.5,6 Low health-literate patients are less knowledgeable about their chronic disease7 and are less able to effectively manage a number of chronic diseases such as high blood pressure, chronic renal disease, diabetes, and asthma.8-11 Low health literacy of parents is also associated with a number of poor health outcomes in pediatrics such as poor asthma12,13 and diabetes control,14 increased use of emergency departments (EDs), incorrect dispensing of medication,15 and decreased rates of breastfeeding.16 In the United States, the economic impact of poor health literacy exceeds $100 billion annually.
Addressing literacy makes a difference
Sometimes pediatricians believe that the societal issues leading to poor health literacy are not really amenable to interventions in a medical practice. Several examples, however, point out that significant differences actually can be made and care can be improved.