Sam sat across from his cardiologist at his follow-up appointment, having been discharged one week ago for a congestive heart failure exacerbation. This marked his fourth time this year requiring treatment from the Emergency Department.

Sam’s heart doctor looked at him somberly, broaching the subject of his health with him once again. Despite being told what he needed to do to avoid another medical intervention, Sam felt helpless. Unbeknownst to the cardiologist, Sam had tried multiple times to lower his salt intake and to adhere to taking his daily medications.

Ultimately, however, he found himself unable to follow the medical advice his doctors gave him. The fact was, Sam’s financial situation and lifestyle choices were not coinciding with what his health demanded of him.

On top of it all, Sam could not admit to his cardiologist that with all the medications he was taking, he did not know which drug was treating his respective ailments. The impossibility of his diet restrictions, compounded with the complexity of his drug regimen, made it impossible for Sam to achieve better health.

Sam’s difficulty in processing and adhering to medical instruction is not an unfamiliar story. Millions of Americans across the country face numerous obstacles including social, personal, and societal barriers that prevent them from healthier living. In the public health field, this phenomenon is called health literacy.

Health literacy is defined as a patient’s ability to read, process, and comprehend medical topics. In today’s climate, being literate with medical terminology has never been more imperative. Still, there are millions who face difficulties despite the advances in medical literature. A significant percentage of the population do not vocalize their impairments.

Why Knowledge Matters

The main drive to improve health literacy is due to the fact that it contributes to the financial burden on the American health system. According to the CDC, in 2016, the United States faced a total national health expenditure of $3.3 trillion. For this reason, a push for preventive techniques and treatment outside of the hospital network will be essential.

With such astounding national debt, one might wonder how the lack of health literacy factored in. Simply put, medically illiterate patients may not understand disease processes, and are less likely to understand how their own actions are worsening their health. Consequently, the illiterate are more likely to seek emergent care at the hospital.

This results in incurring spending that could have otherwise been avoided with proper outpatient management.

Moreover, the future of medicine requires an emphasis to control chronic illnesses. Obesity, heart disease, high cholesterol, and diabetes are in part lifestyle-based choices. For this reason, a person’s ability to read and understanding information will play an enormous role in curbing unnecessary expenditures on the healthcare system.

Health literacy is applicable in infinite public health situations. At any given moment, medical information is spewed to the public with the intent of improving health. Despite the plethora of sources on the internet, the ability to handle the medical content is both individual and societal based.

Promoting Understanding

The challenge for the community is to not make assumptions that patients understand medical facts. Rather, the ability to understand medical facts and make appropriate health decisions is dependent on a complex interplay of factors.

First, one’s level of education contributes to their ability to make informed decisions. The CDC reports that those who live in lower income neighborhoods and those who have less education face hindrances to their health. Their illiteracy makes reading labels and prescription instructions incredibly difficult to adhere to. For this reason, a patient’s best health is not attainable.

One’s own culture can stand as an obstacle against obtaining better health. For instance, some cultures have cuisine staples that are heavy in carbohydrate content including pastas, beans, and rice. This works in stark contrast to the rising obesity issue that plagues the American health landscape.

If a doctor advises a patient to cut back on carbohydrates to lose weight, it can result in resistance. A patient is less likely to give up cuisine that is tied to their culture and their personal identity. What results is that dialogue about alternative foods needs to take place in order to have effective change.

Health literacy can be accomplished by presenting medical information by using simpler language. Numerous patients have claimed difficulty understanding what their doctors educate them about. Patients’ unfamiliarity with diagnosis, tests, and results means that patients find it difficult to grasp the issues in their health.

What occurs is a lack of clarity within the patient interaction.

Additionally, patients have faced obstacles understanding how often to take medications and the importance of ingesting them at a certain time of day. Other patients have expressed difficulty repeating back the dosage and route of administration to their doctor. Some patients have even admitted to mixing their drugs based on the pills’ similar appearance. In short, there are a multitude of ways that instruction can be misconstrued, resulting in a negative healthcare experience.

The American medical system is trillions of dollars in debt. The imperative will be how to make a community more health literate in order to prevent worsening of expenses.

Improving Education

Improving health literacy can be done in several different ways.

Individually, a person can take more initiative as a patient. If being prescribed a new medication, repeat back instructions to the doctor regarding how to take it. If a new medication is not oral, ask how and where to administer it. If a course of medication is long, ask what the consequences of cutting it shorter in duration.

Additionally, when talking about healthcare, make efforts to educate using simple language. When doing research at home, make sure to check the credibility of the website. Using government and public health department websites means a higher chance of accurate information being reported.

Finally, encourage and utilize preventive methods of healthcare. Cancer screenings such as colonoscopies, mammograms, pap smears, and vaccinations ought to be up-to-date. Patients should vocalize any questions or concerns related to upcoming procedure.

Health literacy may be an obstacle for millions of people. However, shining light onto its existence is an effective step in the right direction. The more dedicated efforts are to communicate, the more efficiently we can collectively improve the health of the American population.

Newtown resident Kristina Tabila, MD, received Internal Medicine training at UCONN. Her passion is pursuing public health related initiatives. Her interests include healthcare education, medical writing, and participating in addressing issues related to underserved communities.