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health literacy

The degree to which a person can obtain, process & understand health information in order to make informed health decisions Epidemiology: - 12% of US population considered health literate for complex medical decisions - 53% of US population considered health literate for most medical decisions - 36% of US with inadequate health literacy - elderly with low health literacy are more likely to - have a lower income - have achieved lower education, - rate their health as fair or poor - have sensory impairment (hearing impairment or vision impairment) [1] Clinical significance: - health literacy is a determinant in patient's participation in their own healthcare - low health literacy can interfere with ability of patients to understand treatment plans & result in poor health outcomes & ineffective use of healthcare resources [1] - low health literacy is the most common cause of medical non-compliance [1] - a common cause of recurrent hospitalization is the persistence of underlying risk factors as a result of low health literacy (GRS12) [2] - lower health literacy associated with higher risk of medication errors - higher health literacy associated with better health outcomes - low health literacy is associated with elevated all-cause mortality [3] - screening for low health literacy will not improve medical compliance Management: - elderly with low health literacy may need assistance with: - filling out medical forms - following the instructions on their medication bottles - understanding written & verbal information presented to them by their health care provider Notes: - health professionals have difficulty detecting low health literacy in elderly patients [1] - patients may do their best to hide their health literacy from health professionals [1] - patients with low health literacy come from all social, ethnic, & racial backgrounds & may function well in other domains [1] - distrust of the medical system & denial of illness are factors that contribute to low health literacy (GRS11) [1]

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References

  1. Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010 - Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - Geriatric Review Syllabus (GRS12) Colburn JL, Westcott AM, Potter JF (eds) American Geriatrics Society. 2025
  2. Kutner M et al Patient literacy and question-asking behavior during the medical encounter: a mixed-methods analysis. J Gen Intern Med. 2007 Jun;22(6):782-6. Epub 2007 Apr 12. PMID: 17431697
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  13. Nutbeam D, Lloyd JE. Understanding and Responding to Health Literacy as a Social Determinant of Health. Annu Rev Public Health. 2021 Apr 1;42:159-173. PMID: 33035427 Free article. Review. https://www.annualreviews.org/docserver/fulltext/publhealth/42/1/annurev-publhealth-090419-102529.pdf
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  15. AHRQ Health Literacy Universal Precautions Toolkit. https://www.ahrq.gov/sites/default/files/publications/files/healthlittoolkit2_3.pdf