90 Million U.S. Residents Have ‘Low Health Literacy,’ IOM Report Says
Ninety million people in the United States -- almost half of the country's adult population -- have difficulty understanding and using health information, according to a Institute of Medicine report released Thursday, the Hartford Courant reports (MacDonald, Hartford Courant, 4/9). The study says that people have problems interpreting hospital consent documents, following instructions on prescription drug labels and understanding a physician's diagnosis and instructions (Neergaard, AP/Newport News Daily Press, 4/8). According to the Atlanta Journal-Constitution, while "health literacy is related to ability to read and write, [the problem] goes further and often afflicts well-educated patients" (Nesmith, Atlanta Journal-Constitution, 4/9). Educational, language and cultural differences between health care professionals and patients contribute to low health literacy, according to the report, which was compiled by an 11-member IOM panel. The report found that patients with "low health literacy" often forgo preventive treatment and are more likely to be hospitalized or seek care in emergency departments. While the report did not estimate the cost of low health literacy, it said that inpatient hospital costs for patients with low health literacy were on average $993 higher than for other patients. The report also noted that poor reading skills add at least $29 billion to nationwide health care spending each year (Hartford Courant, 4/9). The study found that "shame and stigma play a big role" in health literacy, often causing patients to be concerned about their difficulty understanding directions or worried that "the doctor will think they are dumb if they ask questions," the AP/Daily Press reports (AP/Newport News Daily Press, 4/8). According to the Courant, the report indicates that "low health literacy is a far broader problem than previously known." Less than one year ago, the American Medical Association estimated that 40 million people in the United States had problems with health literacy (Hartford Courant, 4/9).
The IOM report recommended in part that the federal government fund a study on ways to improve health literacy; accredited organizations require that schools follow national health education standards; health organizations and medical schools teach health literacy and ways to communicate with patients; and Medicare and health plans establish ways to communicate clear health information using cultural and linguistic competency as a measure of the quality of care. Dr. David Kinding, a University of Wisconsin professor emeritus of health sciences and chair of the IOM panel, said, "I hope this will be a call to action" adding, "It's a public health problem, a societal problem," which will require work from educators, regulators and physicians. IOM President Harvey Fineberg said, "Health literacy ... remains a neglected final pathway to high-quality health care" (AP/Newport News Daily Press, 4/8). Surgeon General Richard Carmona said, "Health literacy can save lives, save money and improve the health care and well-being of millions of Americans" (Hartford Courant, 4/9). The report is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.