Medical Literacy: Read This or Die

Christopher Wanjek

Date: 13 November 2007 Time: 05:27 AM ET

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What you don't know might kill you—and cost the nation a bundle.

More than one-third of American adults have only basic or below-basic literacy in health matters, which costs the United States upwards of $238 billion in healthcare expenditures, according to a government- and industry-funded study.

And by basic literacy, we're talking about merely being able to read a label to determine if a product is for a head cold or diarrhea, or administer a proper dose to oneself or a child.

The health illiteracy cuts across ethnic groups and, not surprising, disproportionately affects the medically uninsured, essentially because of their poor access to healthcare and health information. Ironically, the wasted dollars are enough to provide healthcare and improve literacy for the more than 47 million Americans who lack coverage.

Not you, but maybe a neighbor

Any reporting about this literacy report—led by economist John Vernon of the University of Connecticut and based on the U.S. Department of Education's 2003 National Assessment of Adult Literacy—is preaching to the choir, because most people seeking health and science news online are indeed literate.

Nationwide, about 12 percent of adults are proficient in health literacy and can research correct medical information in books or on the Internet, according to the report, assuming I read it correctly.

Of those on Medicare, Medicaid or lacking medical insurance, however, about 30 percent have below basic health literacy and another 30 percent have just basic literacy. Conversely, only 7 percent of adults with employer-provided medical insurance are illiterate on health matters.

The report, called "Low Health Literacy: Implications for National Health Policy," published in October, doesn't single out the poor and undereducated but rather states that we all must share the blame—from a complicated and cold healthcare system rife with cumbersome forms and dense, jargon-filled language, to a society that tolerates non-universal healthcare and adult illiteracy in general.

The cost of not understanding

The report cites multiple studies conducted in the last decade revealing how dollars add up as health knowledge declines:

Inpatient spending increases by approximately $1,000 for patients with limited health literacy, for they are more likely to be hospitalized, experience bad disease outcomes, and have higher mortality rates.
Adults with low health literacy are less likely to comply with prescribed treatment and self-care regimens, make more medication or treatment errors, are less likely to use preventive care, and they lack the skills needed to navigate the healthcare system.
Low functional literacy may be responsible for $32 billion to $58 billion in healthcare spending, a substantial part of expenditures financed by Medicaid and Medicare.

High-tech, low-tech

The United States remains one of the most technologically advanced countries. Genome-wide association studies are revealing the genetic causes of chronic diseases, such as heart disease and diabetes. Therapies will be developed based on this information to provide custom medication with limited side effects.

But these high-tech advances will be greatly minimized, the literacy report states, if low-tech fundamental needs are not met, such as access to basic healthcare, basic health and nutrition information, and the ability to read and follow instructions.

Despite powerful new drugs, health literacy can make all the difference between gaining excess weight, developing pre-diabetes, developing full-blown diabetes, requiring expensive medication, requiring expensive kidney dialysis, losing your vision, losing a limb, and dying prematurely.

Christopher Wanjek is the author of the books “Bad Medicine” and “Food At Work.” Got a question about Bad Medicine? Email Wanjek. If it’s really bad, he just might answer it in a future column. Bad Medicine appears each Tuesday on LiveScience.