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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 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] - 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 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
  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
  3. Bostock S and Steptoe A. Association between low functional health literacy and mortality in older adults: Longitudinal cohort study. BMJ 2012 Mar 15; 344:e1602 PMID: 22422872
  4. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011 Jul 19;155(2):97-107. Review. PMID: 21768583
  5. Garcia CH, Espinoza SE, Lichtenstein M, Hazuda HP. Health literacy associations between Hispanic elderly patients and their caregivers. J Health Commun. 2013;18 Suppl 1:256-72. PMID: 24093360 Free PMC Article
  6. James BD, Boyle PA, Bennett JS, Bennett DA. The impact of health and financial literacy on decision making in community-based older adults. Gerontology. 2012;58(6):531-9. PMID: 22739454 Free PMC Article
  7. Ali NK, Ferguson RP, Mitha S, Hanlon A. Do medical trainees feel confident communicating with low health literacy patients? J Community Hosp Intern Med Perspect. 2014 Apr 14;4. PMID: 24765262 Free PMC Article
  8. Grice GR, Tiemeier A, Hurd P et al Student use of health literacy tools to improve patient understanding and medication adherence. Consult Pharm. 2014 Apr;29(4):240-53. PMID: 24704893
  9. Negarandeh R, Mahmoodi H, Noktehdan H et al Teach back and pictorial image educational strategies on knowledge about diabetes and medication/dietary adherence among low health literate patients with type 2 diabetes. Prim Care Diabetes. 2013 Jul;7(2):111-8. PMID: 23195913
  10. Glass AP, Butler DQ. Health literacy and older adults. J Am Geriatr Soc. 2010 Jan;58(1):152-3. PMID: 20122046
  11. Yen PH, Leasure AR. Use and effectiveness of the teach-back method in patient education and health outcomes. Fed Pract. 2019;36:284-9. PMID: 31258322