How does poor health literacy affect public health and the healthcare system overall?

1 page minimum- AMA format response to discussion question below:

How does poor health literacy affect public health and the healthcare system overall? Consider health decisions, health outcomes, costs, error rates, as well as family and community health. Discuss this question from various stakeholder viewpoints (i.e. policy makers, citizens, administrators, providers, patients, caregivers).

1/2 page minimum AMA format response to classmate Kristen’s post for discussion question

Impacts of Limited Health Literacy

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Social determinants of health are defined by the authors of Health Literacy: A Prescription to End Confusion as “conditions over which the individual has little or no control but which affect the ability to participate fully in a health-literate society.”1, pg 34 Health literacy is aptly characterized as one of these conditions. Even from our initial readings, it is evident that health literacy can have a massive influence on everything from individual patients to the healthcare system overall.

On the individual level, it is hard to imagine that a person who knows or understands little about their health would have the ability to take action to protect it. Although research is still somewhat uncertain about the causal relationship between knowledge and health-promoting behaviors, it seems abundantly clear that a lack of knowledge and understanding can only hinder health-promoting behaviors. We know from our readings that people with limited health literacy are not as likely to use preventive services as those with adequate health literacy, and instead are more likely to need services to treat conditions once they have progressed.1Additionally, mortality trends show that while overall death rates are decreasing, the rate of decrease has slowed for lifestyle-related, chronic conditions including heart disease, stroke, and diabetes.2 These conditions often require long-term care and strong self-management skills on the part of the patient – skills that are lacking for many with limited health literacy.1

Limited health literacy can also have impacts on the macro level. As I learned in my Public Health Policy & Management course, preventative care is much cheaper and more cost effective than emergency or chronic care.3 Indeed, one estimate indicated that additional costs related to inadequate health literacy was at least $29 billion in 1996.1 This is one example of how the impact of limited health literacy reaches beyond the individual patient and stresses the overall system. Time is another example. As anyone who works in healthcare knows, time is a limited commodity; providers, nurses, administrators, and even reception staff never seem to have enough of it. When we consider the additional time that a person with limited health literacy might require, from providers and nurses taking extra time to explain a procedure or a medication, to front-end staff explaining insurance or giving directions – not to mention the amount of time spent correcting issues that result from a patient doing any of those things incorrectly – we can see how quickly all that time can add up.

References

1. Nielsen-Bohlman L, Panzer AM, Kindig DA, eds. Health literacy: a prescription to end confusion. Washington, DC: National Academies Press; 2004.

2. Ma, J., Ward, E. M., Siegel, R. L., & Jemal, A. (2015). Temporal trends in mortality in the united states, 1969-2013. Jama, 314(16), 1731-1739. 10.1001/jama.2015.12319

3. Winter RE. Unraveling U.S. Health Care: A Personal Guide. 1st ed. Lanham, MD: Rowman & Littlefield Publishers, Inc.; 2015.

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