A common misconception among most people is that just because you can read you are literate. Not true. What if you don't understand what you are reading?
What do you think when you read the word "Hypertension"? Of course if you are a doctor or nurse, or actually suffer from this and have learned what it is you would know. But what if you have never heard this term before, you go to your doctor, and they say, "well you are suffering from hypertension so I want you to take this prescription and come back in a month." If you don't specifically ask what it means what would you think? I am too tense maybe?
A study done by the CDC (Centers for Disease Control) back in 1996 showed that patients with low literacy thought the term "high tension" (what they used to call hypertension) meant "a disease of the nerves caused by stress, worry, or an anxious personality." The book Explaining Illness: research, theory, and strategies, written by Bryan B. Whaley, says that these patients "believed the way to treat "high pretension" was to rest and relax-to take it easy."
I looked up the word and it means, High Blood Pressure. I don't even know what that means. The medical websites say it is high tension in the arteries. Well what does that even mean? There are a lot of words that I did not understand when I tried to look it up. Systolic, Diastolic, oh and then there was pre-hypertension.
Basically after wading through all those terms I got to the heart of the matter, and basically if you have a "High Blood Pressure" (what is high anyway), you could die from it.
So if an adult, with only a 3rd or 4th grade reading level, or an immigrant who does not understand the language very well and is maybe somewhat intimidated by the whole health care system was told they have "hypertension" with no other explanation; would they know what it meant? Would they know where to go to find out? What is the likelihood that they will do what is required to take care of it?
Here is another example. You walk into a doctor's office and the receptionist hands you the "Privacy Statement" that you are required to sign. If you are like me you just sign it without really thinking about it, because let's face it I am there to see the doctor and whatever I need to do to get into that room faster and get out and on with my life I am going to do.
But I challenge you to actually read it the next time, and tell me honestly if you recognize all of the words and acronyms that are used throughout. Here is an excerpt taken from a local doctor's privacy statement:
Okay, because I am pretty well read and went to college and was forced at college to learn most of the words in this paragraph, I think I can easily figure out the gist of it. But what about an adult that only reads at a 3rd grade level. Do you think they would understand this paragraph? The word "Pursuant" for example. Or "Provision" or "Disclosure".
These privacy statements aren't life threatening, and they aren't meant to hurt us as patients, but they are confusing and somewhat intimidating in nature. Isn't that how most forms are at the doctor's office, or hospital, or clinic?
I went to an in-service on Tuesday at the Plainfield Public Library. It was titled: "What Adult Literacy Tutors can do to Increase Health Literacy." This workshop was taught by a well known expert in the field of Health Literacy. She is one of the founders of the Health Coalition of NJ and has given many workshops to tutors, students, and even health care professionals.
First question: What is Health Literacy? Well Health Literacy is defined many different ways actually, and has changed throughout the years. One definition put forth by The Centre for Literacy of Quebec states:
- Health literacy allows the public and personnel working in all health-related contexts to find, understand, evaluate, communicate and use information.
- Health literacy is the use of a wide range of skills that improve the ability of people to act on information in order to live healthier lives.
- These skills include reading, writing, listening, speaking, numeracy, and critical analysis, as well as communication and interaction skills.
Honestly it never occurred to me how really cut off low literate people are from really understanding health care. I am thankful for this workshop, for opening my eyes to the facts.
I learned that according to the 2003 National Assessment of Adult Literacy that 88% of the country is below the proficient level in health literacy. To me that is way too high and it is so obvious that there is a clear disconnect between how the information is being given to us and how it is received.
So what can be done? The workshop presenter gave us tutors, tips and ideas, and resources to use to help introduce the topic into our tutoring. But she also mentioned that it is a two way street. She feels, and I agree, that the health care providers need to learn to make it simple. That doesn't mean dumb it down, it means make it easier for everyone to understand the important information that we as patients need to know. And maybe doctor's and even nurses could take a little extra time to make sure their patients really understand and not just assume that they do.
My mother is a nurse and I have an aunt who is a doctor, and I have many friends who are in medical professions. I love these people and have learned many important things from them, and because of them I do not feel intimidated to ask questions. But I know many people still are, and I challenge those who work in this profession to learn to look out for these patients. In the mean time I will do my best to help my student with whatever health literacy needs she has or wants.
If you would like more information about Health Literacy in NJ, please click here:
1 comment:
As you state, medical jargon is confusing even for the college educated, but I can see how those with limited English skills would feel "in the dark" on these subjects. Thanks for enlightening us!
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