Low health literacy is pervasive barrier to care

Reports on patients' inability to understand health information point up the need for clear physician communication.

By Susan J. Landers, AMNews staff. April 26, 2004.

Washington -- How hard can it be to select the proper spoon to administer medicine? Surprisingly difficult, actually. The Institute of Medicine found that very few people could pick out the one that holds a traditional 5 mL of liquid.

This test is one of the ways the IOM panel illustrated its point that nearly half of all American adults, or 90 million people, have difficulty understanding and using the health information that is dispensed in physicians' offices and in hospital discharge instructions.

A companion report, "Literacy and Health Outcomes," written by the Agency for Healthcare Research and Quality and requested by the AMA, confirmed that low reading skills and poor health are clearly related.

"Limited health literacy is a huge obstacle standing between millions of America's patients and the health care they need and that physicians wish to deliver," said AMA President-elect John C. Nelson, MD, at an April 8 briefing to release the two reports.

Low health literacy is a pervasive problem that can result in patients being unable to understand basic information presented by their doctor, the studies concluded.

"Tens of millions of U.S. adults are unable to read complex texts, including many health-related materials. Arcane language and jargon that become second nature to doctors and nurses are inscrutable to many patients," according to the IOM report "Health Literacy: A Prescription to End Confusion."

However, the AMA has been aware of the problem for some time and has developed several approaches for physicians to use when communicating to patients.