Speaking simply improves health care
October is Health Literacy Awareness Month
by Jennifer Hilliard
Edyth Martin calls it “talking in plain English.”
As the primary caretaker for her 14-year-old grandson, Joey Wilson, who has multiple health problems, she knows the importance of health literacy. She’s the one who takes Joey to physician visits at MCG’s Children’s Medical Center.
“At first they would talk over my head,” she says of the seemingly endless trail of doctors who’ve treated Joey. “I got to be known as Grandma and I’d always tell them, ‘Talk to me in plain English so I’ll know what I’ve got to do when we leave here.’”
Joey has a seizure disorder, scoliosis, severe cerebral palsy and mental retardation – just a few of the lasting results from a brutal attack on his mother when she was nine months pregnant. He has survived 11 major surgeries in his short life and requires a feeding tube and supplemental oxygen 24 hours a day.
Joey requires constant care that can include anything from suctioning the reservoir at the base of his spine to simply knowing his medicine schedule to cleaning his naval where the tube that feeds him connects. Mrs. Martin does it all – something she says wouldn’t have been possible without health care providers explaining things in terms she could understand.
“They taught me everything that a nurse would have to know,” she says. “Joey takes several medications four times a day. I have to know what medicine goes with what medicine and the exact amounts of the dose. The doctors worked with me to figure out a schedule.”
The unfortunate thing, according to Gayle Bentley, an assistant professor of biobehavioral nursing at the School of Nursing, is that Mrs. Martin may be one of the exceptions.
“She sought out clarification in communications about her grandson,” Dr. Bentley says. “A lot of people wouldn’t do that. Navigating the health care environment is a challenge for most Americans. Low health literacy presents complex issues for individuals and families, and can be barriers to getting the best health outcomes.”
According to the National Network of Libraries of Medicine, health literacy is the ability to obtain, process and understand basic health information and services needed to make appropriate health decisions. Put simply, people need to be able to understand often complicated health diagnoses and treatment plans.
“Health care providers need to communicate in plain language and that includes both verbal and written communication,” says Dr. Bentley. “Health literacy skills are needed for a wide variety of things, including dialogue with health care providers, reading health information, making decisions about treatments, carrying out medical treatments – such as a tube feeding – calculating timing or the dosage of medicines and even choosing to get screenings for chronic conditions.”
Studies suggest that while individuals with limited health literacy come from all walks of life, the problem is greater among people with general literacy issues – older adults, people with limited education and those who speak English as a second language.
“All of the research indicates that even people who are well-educated and fully literate have problems understanding health-related terms,” Dr. Bentley says.
And it can be a complex problem.
According to the American Medical Association, poor health literacy is “a stronger predictor of a person’s health than age, income, employment status, education level and race.”
For example, a person who has trouble reading a medication label might take it erratically, which could cause future health problems.
October is Health Literacy Awareness Month.
The key to helping the approximately 90 million Americans who lack health literacy, Dr. Bentley says, is increasing literacy rates in the community and ensuring that future health care professionals understand and address the relationship between health literacy, clear communication and health outcomes.
The School of Nursing has incorporated health literacy education into its curriculum.
“It’s a problem that needs to be addressed at all levels,” Dr. Bentley says. “It should start with awareness from providers and should also be an essential concept in the education of health professionals. It is a concept critical to patient- and family-centered care and it should be important to everyone involved in health promotion, disease prevention and heath care delivery.”