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Poor A1c Tests Related to Low Health Literacy in America
posted 04/16/04
As many as 90 million American adults lack the reading and math skills needed to understand basic health information and navigate the U.S. healthcare system, according to a report issued Thursday by the Institute of Medicine (IOM).

The report's authors stressed that the problem goes beyond the problem of low general literacy skills among adults, extending from persons who do not speak English as a first language to educated individuals who have a hard time interpreting complicated medical advice from physicians.

The problem affects virtually all areas of U.S. healthcare, from misleading food labels and drug information to overly complicated informed consent agreements and government forms that prevent many people from accessing needed public health services, according to the report.

The study also calls on U.S. physicians to improve the way they communicate with low-literacy patients and asks medical schools to make better communication a routine part of student training.

"In health there's such a very high dependency on understanding," said IOM president Harvey Feinberg, MD, PhD. "Every time there's a misunderstanding [between a physician and a patient], there's a risk of life loss."

The report points to an increasingly complex healthcare system that asks patients to decipher complicated information about multiple medications, surgical procedures, caloric intake, and a host of other issues. "These demands exceed the health literacy skills of most adults in the United States," it says.

David A. Kindig, MD, PhD, chair of the IOM panel said that “even those who read well have a hard time figuring out information from their insurers, physicians, or pharmacists.” "They're still confronting the healthcare system with all its complexity," said Dr. Kindig, a professor emeritus of population health sciences and co-director of the Wisconsin Public Health and Health Policy Institute at the University of Wisconsin School of Medicine in Madison.
The problem was also highlighted last month when Health and Human Services Secretary Tommy G. Thompson announced that his department would ask food manufacturers to simplify food labels to help Americans make better dietary choices.

The IOM panel reviewed 684 articles and studies looking at how low education levels and complex medical information affect healthcare in the U.S. Only a handful actually looked for direct links between poor health literacy and adverse medical outcomes.

One study found that individuals with poor literacy skills had significantly more preventable hospital visits than those with higher skills. Another showed more unnecessary emergency department visits in the lower skills group.

Another study estimated that low literacy skills cost the U.S. healthcare system $69 billion per year, though the study has not been confirmed, according to the report.

The report calls on medical schools to train physicians-to-be on how to better communicate with a broader range of patients. The AMA has launched an information kit for physicians, urging them to simplify information for patients and to listen closely to patients' questions to see if they understand medical advice.

The IOM's report also says that few physicians have enough time in busy clinics to sit with patients long enough to make sure they understand advice.

Source: Diabetes In Control.com.

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