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Three little questions can help address health care literacy

Saturday, May 19, 2007 | 12:00 a.m. CDT; updated 1:03 a.m. CDT, Friday, July 18, 2008

Ever leave your doctor’s office more confused about your health issues than when you walked in? You might be suffering from more than physical ailments.

Low “health literacy,” an individual’s ability to obtain, process and understand health information and the services needed to make appropriate decisions and follow instructions for treatment, can put you at risk for unnecessary hospitalizations, emergency treatment and medication errors.

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  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do this?


A recent government study revealed that the problem is epidemic. Estimates are that more than 89 million American adults have low or limited health literacy skills. People of all ages, groups, income and education levels are challenged by the problem, but the elderly, who may have hearing, vision or cognitive loss, are particularly vulnerable.

Health literacy includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor’s directions, food labels and consent forms and the ability to negotiate complex health-care systems. Not simply the ability to read, health literacy requires reading, listening, analytical and decision-making skills, and the ability to apply these skills to health situations.

“If you leave your doctor’s office not really understanding what was discussed, if you can’t make out prescription directions, you’re not going to be able to follow a treatment plan properly,” says Gabriel Martinez, director of sales and marketing for Senior Whole Health. The Massachusetts health-care company is part of The Partnership for Clear Health Communications, a national coalition working with health-care providers and consumers to raise awareness and provide solutions. “Health literacy skills are a stronger predictor of a person’s health status than age, income, employment status, educational level and racial or ethnic group,” Martinez said.

Compounding the problem is that many older patients hide their confusion from their doctors because they are too ashamed or intimidated to ask for help. Martinez advises seniors to arrive at health-care visits prepared with a written list of symptoms and current medications, both prescription and over-the-counter.

Bringing along another pair of ears, such as a caregiver, friend or adult child, is another way to sort information. But the real key to higher health literacy, he says, is knowing the right questions to ask.

Ask Me 3, The Partnership for Clear Health Communication’s community-based educational initiative, visits senior centers, elderly housing, community centers and churches to teach seniors three simple queries: What is my main problem? What do I need to do? Why is it important for me to do this?

“These questions are designed to empower seniors, giving them the basic queries they should pose to their doctors, pharmacists or nurses when preparing for a medical test, a procedure or when they get their prescriptions filled,” says John Baackes, chief executive of Senior Whole Health. “Asking the right questions will help them to understand how to get better.”

Better understanding can also affect health-care’s bottom line. Costs caused by excess hospitalizations and emergency care, errors by patients in their self-treatment and problems associated with limited health literacy are estimated to be $58 billion to $73 billion a year.

The U.S. Department of Health and Human Services has made health literacy part of “Healthy People 2010,” its list of national health objectives. In a statement on the issue, former Health and Human Services Secretary Tommy Thompson said, “Health literacy can save lives, money and improve the health of millions of Americans. ”


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