Health Literacy

Abstract

Case presentation: A 67-year-old retired school bus driver presents to your office for an initial visit after having had an acute myocardial infarction, which is complicated by new-onset congestive heart failure. She comes to your office alone, with a bag of 5 pill bottles, and asks, “Do I really need all these pills?” To care for themselves and participate in their health care, patients must be able to understand and act on information and instructions given to them by their healthcare providers. This concept is known as health literacy, which is defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and health services needed to make appropriate health decisions.”1 Basic literacy skills, such as proficiency in reading, writing, listening, interpreting images, and interacting with documents, as well as facility with numeric concepts and basic computation, are central to the concept of health literacy and greatly affect a patient’s level of health literacy. The Institute of Medicine, American Medical Association, American College of Physicians, and the Joint Commission have targeted health literacy as a cross-cutting priority area for quality improvement to transform US health care.2–5 Patients with the largest disease burdens are often those with the least ability to understand and use health information. This is due in part to a lack of focus on patient education and poor communication skills by clinicians. In this article, we discuss the prevalence of limited health literacy, its impact on health outcomes and healthcare utilization, and strategies that providers may use to enhance their communication skills. …