The health literacy deficit

New Senate legislation would provide much-needed tools to address this continuing health problem.

Editorial. Jan. 28, 2008.

Think about the complicated treatment regimens with which your patients grapple.

An American Medical Association Council on Scientific Affairs report used the example of an asthma patient. This patient needs to know how to monitor his or her condition with a peak flow meter. He or she also has to understand how to select and use inhalers, utilize rescue or other medicines, and avoid triggers that could cause an attack. And the patient should know when to go to the emergency department, a primary care physician or a subspecialist.

Of course, this list includes only a slice of such a patient's daily self-care activities. And information -- as well as the reading and computational abilities to process it -- is critical to success.

It's a skill set known as health literacy -- a term of art defined by the Institute of Medicine as the degree to which people can gather and understand the basic health information and services needed to make sound decisions. Unfortunately, about 90 million people in the United States fall short. The results can be tragic.

Numerous studies have shown that patients with poor health literacy have worse health status than do those who are more proficient. They tend to face strikingly higher mortality rates. And those with chronic diseases, such as diabetes, asthma or hypertension, have less knowledge about their diseases and treatments.

Because of this reality and its dire consequences, the AMA applauded the introduction late last year of the National Health Literacy Act of 2007. The AMA was the first national medical organization to adopt policy recognizing that limited patient literacy affects medical diagnosis and treatment.