Health literacy ensures that patients not only get the care they need but also understand their diagnosis and treatment plan.Health literacy is broadly defined as a person's ability to:
Seek out and find accurate, reliable health information
Read and process the information they find
Utilize the information to make appropriate healthcare decisions
Unfortunately, only about 12% of adults in the U.S. have "proficient" health literacy skills, another 53% have intermediate literacy, and as many as 36% — more than one in three people — have health literacy at the "basic" or "below basic" level.
Low health literacy disproportionately affects:
People with low income or low socioeconomic status
Medically underserved communities
Underrepresented groups, including those with limited-English proficiency (LEP)
Low Literacy Among Limited-English Speakers
When hospitals and providers implement programs to expand accessible care for limited-English speaking patients, it's important to understand the extent of low health literacy. One study examining various social determinants of health found that LEP patients were four to five times more likely to need health literacy assistance than English-proficient populations. The percentage of adults with basic or below basic health literacy among Hispanics (65%) is more than twice as high as Whites (28%).
It's important for healthcare providers and facilities to understand the different ways patients obtain and analyze health information. Some patients — especially those with higher health literacy — can read written information such as handouts or digital resources to learn more about diagnoses and treatments. But most low-health-literacy patients are far less likely to use print or digital resources.
Only 15% of adults with below basic literacy sought out and used information from the internet on health topics. By contrast, 62% of proficient health literacy patients use these resources. This demonstrates why a translated written document or a referral to a website with information about an LEP patient's diagnosis might not be enough.
Implications of Low Literacy on Health
Low health literacy is often difficult to see. Many people who come to a doctor's office or hospital find ways to avoid the shame or embarrassment of not being able to read and understand information about their care.
Medical terminology and information are complex, even for people who have a high level of understanding. Getting diagnosed with a serious illness or a complex condition can add to that anxiety, especially for someone who doesn't clearly understand medical terminology or how their bodies work. All of this complicates a patient's ability to make informed decisions about their care.
Someone with low health literacy is more likely to:
Experience medication errors, including dosing or schedule errors
Be noncompliant with medications or treatment plans
Visit the emergency room for non-emergency care
Have complications when managing chronic health conditions
Be readmitted to the hospital after discharge
Experience longer hospital stays
Misunderstand information during a public health emergency
Low health literacy contributes to more medical errors, increased rates of illness and disability, and lost wages that add up to more than $236 billion a year.
Creative Ways to Engage With Patients
When providers identify patients with low health literacy, it's essential to find creative ways to engage with them for a better overall care experience and better outcomes. While it can be difficult to identify the people who come to a clinic with low health literacy, you can look for signs like:
Inability to complete written registration forms
Inability to name their medications, dosage, or the purpose of taking them
Poor ability to recall information about their medical history or treatment
Frequently missed appointments
Excuses to avoid reading written materials, such as forgetting reading glasses or being too tired to read the information
To help LEP patients with low literacy feel more comfortable, every clinic should have medically qualified interpreters available to communicate with the patient verbally. Having written material translated to the patient's native language is still important, but providing real-time verbal translation (not just interpretation) will ensure that even low-literacy patients get the information they need.
Providers and clinical staff should also:
Provide translators at check-in and check-out to help fill out the required paperwork
Listen carefully to the information that a patient shares through a translator about their health and concerns
Pay attention to nonverbal cues that indicate a person might not fully understand the information they are receiving
Once you identify LEP patients with low health literacy, the next step is to help them get the resources they need for better care outcomes. Download our guide, Designing Your Ideal Language Access Plan, to learn how a qualified language service provider like GLOBO can help.
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