Smith on Social Marketing
90 Million Americans Need Health Literacy
As a member of the Institute of Medicine’s recent committee on health literacy, it was shocking for me to discover that 90 million Americans—nearly half of all adults—have a health literacy problem.
They can’t use charts, calculate percentages or make sense out of drug labels, consent forms, or medical histories. The lack of these skills is associated with worse health outcomes and increased health care costs. This is a practical management problem as well as a deeply troubling human problem.
So, we need to have mass literacy classes, right? Not that simple. This is a social marketing challenge. This is truly a systems problem, not just a person problem. We need to make consent forms simpler to understand, and not assume that everyone can read a chart or graph. We must recognize that all health information goes through a cultural filter that is not limited just to foreign-born Americans.
For example, it is not uncommon for doctors to ask older Americans to stop taking a favorite medication, to find out later that many of them have horded it “in case they need again” – or continued taking it because they think it “helps them.” If you ask adults who have hidden the fact that they can not read to fill out a medical history, they often ask for help “because they forgot their glasses.” The problem of health literacy is more widespread than we ever imagined.
It is another silent epidemic, not so easy to detect. Health literacy is a characteristic of a society and not just of an individual. America should be judged on whether it is a health-literate country. Hospitals, medical practices, pharmaceutical companies, health care insurers or providers, workplaces, and schools should all be judged on whether or not they are health literate institutions.
As a social marketer, here are three questions to ask about your own institution or practice:
1. Do I know how many individuals have a health literacy problem where I work?
2. Have the health care forms we use been tested for health literacy?
3. Would individuals with a health-literacy problem in my workplace feel free to discuss the issue with their supervisor or HR office?
We all have a role to play in breaking down the barriers to making America a health-literate society, and it goes far beyond promotion.
Schools can include health content in language and math lessons. Adult education can teach specific health problems and content.
The private sector can test its print materials for clarity. The government can enforce policies for clear language and institute simple testing of public healthy materials. Health journalists can improve and share their health communication skills with others. Public transportation authorities can create bus schedules that are easier to use so folks can make it to their medical appointments. And physicians and their support staff can do more to check whether patients understand and can make appropriate decisions based on what they have been told.
The outcome of poor health literacy for patients and consumers is increased confusion, less motivation to seek care, and ultimately, inequities in health care access and quality. As modern health care becomes more complex and more dependent on patients to be their own advocates, problems of health literacy become increasingly urgent.
Read more about AED's work in U.S. health issues.
Read more about Bill Smith.
