The Heller School for Social Policy and Management, Brandeis University

National Program on Women & Aging

Women & Aging Letter
Excerpt - Winter 2001

Health Literacy:  Sharpening Your Skills
Volume 5, Number 1

When patients enter the doctor's office for the first time, they are handed a clipboard with a set of forms to complete. For patients with low health literacy, this can be the beginning of an anguished journey into our health care delivery system. Even those who are knowledgeable can find the process of getting and conveying information about their health nerve-wracking.

Health literacy is the ability to understand and communicate health information. Health care professionals and researchers are worried about the effect of low health literacy on the health of millions of Americans. We need to increase awareness of health literacy issues as an important step toward addressing the problem. In this issue of the Women & Aging Letter we try to help you understand what health literacy is and how to better communicate with health care providers.

What Is Health Literacy?

Health literacy refers to the ability to read, understand, interpret, and act on health care materials and information. Understanding health information requires not only basic reading, writing, and mathematical skills, but also some knowledge of health concepts, health vocabulary, and anatomy.

Individuals with health literacy problems are likely to be less healthy and to practice higher risk behaviors. They are more likely to develop diseases or to aggravate chronic conditions. For example, research conducted at urban public hospitals showed that many patients found it difficult to read appointment slips and to understand details on prescribed medication bottles. These patients, all English speakers, had difficulty following recommended treatment and were more likely to be hospitalized.  Low health literacy also increases health care costs. A recent study showed that health literacy problems cost over $70 billion a year in unnecessary doctor visits, hospitalizations, and longer hospital stays.

Inadequate health literacy affects all age and economic groups. But its strongest impact is on the poor, the elderly, and racial and ethnic minorities. The elderly population, especially older minorities, will continue to grow. Thus it is important that we address what is becoming a major public health issue for a significant segment of the population.

What's a Patient to Do?

Patients, even those who try hard to inform themselves before a doctor's appointment, often complain that their doctors speak too fast, give them too much information, and use complicated words.  There is an increasing amount of health information, much of it complex, that we must comprehend, evaluate, and communicate. Moreover, those who care for us -- family members, formal and informal caregivers, health care providers -- are frequently called on to understand this information on our behalf. Understanding and communicating health information can be a daunting task for anyone, but for those with low health literacy, the challenge is enormous.

If you find it hard to understand medical information or instructions, there are several things you can do to help:

  • Don't be ashamed to ask questions. Ask any and all questions you have, even if you think they're silly, and keep asking them until you understand the answers.
  • Develop a list of questions about your condition and treatment before you go to  medical appointment. Make sure they are written down. Take the list with you. Make sure you ask all the questions on your list during the visit or give a copy to your doctor.
  • Write down the answers or have your health care provider write them for you. Have a friend, family member, or primary caregiver help you understand the answers.
  • If the answers seem too complicated to write down and understand, ask your health care provider to provide some kind of chart or other visual cue to help you understand them.
  • Find out who to call if you have other questions once you get home.
  • When you get your prescription medicine, make sure it's what the doctor ordered for you. Make sure you know how much and how often you need to take it. Ask your pharmacist if you're not sure.
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