Perhaps you’ve heard the story about the 66-year-old Pennsylvania woman who, whenever she visited her doctor’s office, would tell the office assistant that she’d forgotten her eyeglasses or that her hand was sore. She wasn’t saying that to avoid writing a check for her co-payment. Rather, she was trying to conceal the sad truth – she couldn’t read or write.
Or how about the young mother whose small child had an earache. She took the child to the pediatrician, who diagnosed an ear infection and prescribed a liquid antibiotic. The young mother filled the prescription – then, when they got home, she poured the medicine into her child’s ear instead of giving it by mouth, which is the way it should have been given.
Both the woman from Pennsylvania and the young mom are among the 90 million Americans that the Institute of Medicine believes are suffering from a lack of health literacy.
If you think this isn’t an issue that concerns the business community, think again. Last year, the National Academy on an Aging Society reported that the lack of health literacy costs the country’s health care system about $73 billion per year. Much of that is money that employers and their workers pay in health insurance premiums.
There are many barriers to health literacy, and many of them have nothing to do with cultural differences, poor education, or language barriers. Sometimes doctors’ instructions are too complex to understand. So is a lot of written material about health care. Often, patients or their loved ones become overwhelmed by bad health news and their comprehension falters.
A little more than two years ago, some of the most important organizations in Rhode Island’s health care system – the Hospital Association of Rhode Island, the Rhode Island Medical Society, Brown University Medical School, Blue Cross & Blue Shield of Rhode Island, the R.I. Department of Health, Quality Partners of Rhode Island, to name just a few of them – got together to try to improve health literacy in the state.
The result of that collaborative effort is the Rhode Island Health Literacy Project (
www.RIHLP.org). The project has made impressive strides in a relatively short time. A few of the project’s achievements to date are:
• Published health literacy guidelines for written health care materials.
• Published and distributed a “toolkit” for physicians to help them to better communicate with patients. The toolkit includes specific information about advance directives, a topic that some doctors find difficult to broach with their patients.
• Created a Check-up Checklist (in English and Spanish) to help patients get the most from their doctor visits. These are reaching patients through hospitals and clinics across the state.
Most recently, the project finished work on a basic health literacy curriculum for adults with poor reading skills and low education levels. The project was painstakingly researched, and underwent tests in two different pilot courses taught at Dorcas Place Adult and Family Learning Center in Providence. The curriculum was written by a physician with teaching experience and edited by both educators and health care professionals, and it is now ready to be offered to agencies throughout the state that provide basic education to adults.
This is an important accomplishment of the RIHLP, and the work was eye-opening. Early on, for example, there was the focus group at Dorcas Place in which a young man was asked whether he had a primary care physician.
“Yes, I do,” he replied.
How do you access this doctor’s care, the man was asked?
“It’s easy,” he said. “I go to the emergency room with whatever problem I have, and when I get there I tell them who my doctor is. Then they call my doctor for me.”
You see, we still have much work to do if we are to improve health literacy in Rhode Island.
October is national Health Literacy Month. If nothing else, I urge you to visit our Web site (again, it’s www.rihlp.org). There you can find information on all of the material referenced in this article, and much more.
If you think you’d like to help the Rhode Island Health Literacy Project fulfill its ambitious mission, contact us by going to the Web site. We can use all the help we can get. •
Lori Quaranta is chair of the Rhode Island Health Literacy Project steering committee.
