RTI International - News Release - 1.18.2005
Literacy Deficits Adversely Affect Healthcare Use, Outcomes
RESEARCH TRIANGLE PARK, N.C. -- Adults in the United States with lower-than-average reading skills are less likely than other Americans to get tests such as mammograms and Pap smears, to get flu and pneumonia vaccines, and to take their children for regular doctor visits, according to a study by RTI International and the University of North Carolina at Chapel Hill.
The study, published in the December edition of the Journal of General Internal Medicine, was funded by the Agency for Healthcare Research and Quality and conducted by the RTI-UNC Evidence-based Practice Center at RTI.
The findings indicate that people with modest literacy skills are at a disadvantage in caring for themselves because they have difficulty reading directions for taking medicine, understanding surgery consent forms and hospital discharge instructions, and may be unaware of health alerts or even the nutritional content of food products.
"To adequately care for one’s health, literacy is essential," said Nancy Berkman, a research analyst at RTI and the study’s principal investigator. "Our research found that those who lack basic reading skills are less knowledgeable about their own health and how to access the services they need."
Despite numerous literacy efforts, roughly 90 million U.S. citizens lack adequate reading skills, according to the National Adult Literacy Study of 1993, the most recent year for which such figures are available. As a consequence, many people are largely incapable of participating in their own healthcare, Berkman said.
"Among the medical community, there is great concern for adults who can’t read well because self care, particularly when someone has a chronic disease, can be complex," Berkman said. "What happens, for instance, if a senior citizen has to take several medications with potentially adverse interactions? And what if some of the medications must be taken with food? There can be a lot to figure out."
The Agency for Healthcare Research and Quality, the American Medical Association, and the American Hospital Association have implemented various initiatives to address the problem over the years, such as a 2003 campaign that featured posters with tips to encourage dialogue between patients and providers, among other materials.
As part of her project, Berkman and colleagues also identified interventions to help health care providers impart key information to people with lower-than-average reading skills. A manuscript presenting the findings has been accepted for publication this year.