We’ve all been there. Sitting in a cold exam room, tense and nervous, perhaps embarrassed in one of those awkward gowns. Not understanding what the doctor is saying—or even knowing what to ask.
Not knowing how to make informed healthcare choices can take a toll—physical, financial, emotional—even professional.
And the numbers don’t lie. Compared to people with higher health literacy, patients with low health literacy have:
- 40% higher risk of going to the ER
- 55% higher risk of hospitalization from asthma
- 3 times more heart failure hospitalizations
- 3 times higher odds of needing to go back to the hospital in patients over age 64
- Higher risk of early death from heart failure and other causes
- Low health literacy costs the US up to $238 billion a year.
In our 2016 webinar, “Why Health Literacy Matters to Your Business,” leading experts Cynthia Baur, PhD, Endowed Professor and Director of the University of Maryland’s Horowitz Center for Health Literacy, and Dr. Russell Rothman, MD, MPP, Director of the Center for Health Services Research at Vanderbilt University, discussed with EdLogics moderator and population health expert Fred Goldstein how, by focusing on statistics, we may be missing the bigger picture.
Here’s just a small part of what they had to say:
Looking at the wrong problem
Fred Goldstein: Given all of the statistics, what are some of the key reasons patients with lower health literacy experience poorer health and require more care?
Dr. Baur: One of the things I like people to think about is even the framing of that question. Because you are right about the data that’s been collected on people’s experiences and outcomes with getting healthcare services. But that approach of looking at people’s health literacy levels and the use of emergency services and what-not—many times, that approach puts the blame on them. Because it makes them seem like they’re doing things that are inappropriate or costing the system or themselves more money.
Systems on top of systems
Dr. Baur: The reality is that we live in a very complex set of health systems. There are multiple healthcare systems. There’s the public health system. There’s the educational system which influences people’s knowledge and skills about health. So all of those different systems are part of that larger environment in which people are trying to get information and services. …
Health literacy has really been an issue that’s been out there for a while. The data have been accumulating about these costs. We’re at a point where people are taking a step back and saying, if you want patient-centered or person-centered health and healthcare, you really have to look at what people’s experiences with these systems are. You have to look at the challenges they face and the demands being placed on them to try to get information and services. And that will lead us toward looking at organizational practices, system redesign, and ways that will make it easier for people to get what they need.
Lost in the maze
Dr. Rothman: Poor health literacy is a common problem. We know that over 90 million Americans have basic or below basic skills and over 110 million have only basic or below basic quantitative skills, which can make it very challenging in our very numbers-focused healthcare environment.
Even people with good health literacy skills can now struggle to navigate what’s become a very complex healthcare system. Trying to figure out how to take their medicines, how to follow a good diet, how to follow up specific recommendations from providers—even just navigating
where to go in the hospital, or how to get to appointments, or how to navigate insurance—it’s all become very complex. The amount of time patients have to interact with their doctors or other clinicians whether it’s at a clinic or even in the hospital—it’s very short.
The bottom line
Dr. Rothman: There are real opportunities for us to improve how we provide health information to patients and families to help them to improve their health.
The information and opinions attributed to Drs. Baur and Rothman are their opinions only and do not necessarily represent the views of their affiliated organizations, including the University of Maryland, Centers for Disease Control and Prevention, and Vanderbilt University Medical Center.