Health Literacy And Its Importance For Emergency Room Patients

Have you ever thought about how important literacy and reading skills are to your health? The capacity to read and understand medical information becomes especially important when patients visit the emergency room. Most medical information is written at a 10th grade level or higher, so patients who fall below this level can have difficulty understanding their conditions, rights, and treatment options. A recent study pointed out that 90 million adults in the United States have limited health literacy [1].

Literacy skills affect the type of care that individuals receive. Patients with limited health literacy do not have the ability to process and understand basic health information so that they can make adequate health decisions for themselves. The effects of this are far-reaching, both for patients and for emergency room departments. Limited health literacy is associated with a lower quality of life, increased complications from asthma, and reduced use of preventative health measures [2]. Children whose parents do not have adequate health literacy are more likely to visit the emergency room, more likely to be hospitalized, and more likely to miss school days. All of these effects are detrimental to the overall well-being of individuals and families. The full costs of these effects to insurance companies, hospitals, or individual patients are not yet known.

Poor health literacy in patients also puts additional stress on emergency room physicians, who are often tasked with handling several potentially severe cases, and who must work to ensure that patients understand their diagnoses and options for treatment. Some studies have claimed that limited health literacy poses a significant threat to effective patient care in the ER, and that universal precautions should be taken to address it [3]. Research on emergency room departments has shown that low health literacy is associated with greater rates of retinopathy (damage to the retina – usually due to complications from diabetes), worse glycemic control among diabetics, and, among patients with HIV, less understanding of how to prevent transmission to others [4-6].

All of this suggests that patients with limited reading comprehension skills deserve extra attention. Strategies to lessen the communication difficulties between patients and emergency room physicians can include the use of plain language, multimedia communicative techniques, and teach-back methods, although ongoing research is investigating further possibilities. Patients need to be informed about their own health and about appropriate follow-up care (such as taking prescriptions correctly, etc.). Without this, physicians’ ability to help emergency room patients is hampered. Planned follow-up investigations between health outcomes and limited health literacy are likely to include associations between literacy, health care costs, length of stay in the hospital or emergency room, frequency of ER visits, and the nature of emergency room use.

References To Consult for Even More Information:

1. Parker R. Health literacy: a challenge for American patients and their health care providers. Health Promotion International 2000; 15:277-283

2. Kirsch IL. Adult Literacy Survey. Washington, DC: US Government Print Office, Superintendent of Documents; 1993. 20402 (Stock No. 065-000-00588-3).

3. Apter AJ, Cheng J, Small D, et al. Asthma numeracy skill and health literacy. Journal of Asthma 2006; 43:705-710.

4. Baker DW. The meaning and the measure of health literacy. Journal of General Internal Medicine 2006;21:878-883.

5. Shillinger D, Grumbach K, Piette J, et al. Association of health literacy with diabetes outcomes. Journal of the American Medical Association 2002;288:475-482.

6. Kalichman SC, Benotsch E, Suarez T, et al. Health literacy and health-related knowledge among persons living with HIV/AIDS. American Journal of Preventive Medicine 2000;18:325-331.

By: J Cutler