Assessing and Addressing Patients' Health Literacy Challenges

February 12, 2010

Angela Askren-Gonzalez RN, MSN, CMC Editor

I don't understand this! What does this mean?

Most patients are not this open about their inability to understand health education materials because they don't understand the risks of their health literacy deficit. Health literacy is defined in Healthy People 20101 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." Patients often fail to adhere to medical or dietary recommendations because of their poor health literacy. And when providers are unaware of this problem, they are unlikely to teach their patients in ways that empower those patients to successfully manage their health problems.

Inadequate health literacy is a widespread problem. In a large national study conducted in 20032, 14% of adults were determined to be at the lowest level of health literacy (below basic), and 22% were at the next lowest level (basic). Although the majority of participants in this study in the "below basic" level of health literacy had not completed high school, 3% of this group had a bachelor's degree.

Providers should assess the health literacy level of each patient and provide education that is appropriate for that level. It is unlikely that patients will admit that they don't understand health information, so the provider should look for clues, such as patients promising to read education materials when they get home, never having their reading glasses with them, or leaving a lot of blanks on an intake form. When working with patients on the phone, clinicians may be able to identify health literacy deficits if patients frequently put someone else on the phone to speak for them, they avoid reviewing health topics, or if they continue to repeat incorrect medical information even after proper instruction.

What can providers do?

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