Gap in medical understanding called danger to public health

Patients have difficulty correctly using available information, panel says

April 09, 2004|By John A. MacDonald | John A. MacDonald,HARTFORD COURANT

When the mother of a 2-year-old left the doctor's office, she had a prescription for an antibiotic for her daughter's inner-ear infection. At home, she knew her daughter was supposed to take the medicine twice a day, but she couldn't figure out from the label on the bottle how to administer it.

Finally, the mother filled a teaspoon and poured the medicine into her daughter's ear.

The story of how one mother innocently misused a medicine comes from a report released yesterday that said 90 million Americans - nearly half the nation's adult population - have difficulty understanding and using health information.

This "low health literacy" might lead to billions of dollars in avoidable health care spending, said the report, prepared by the Institute of Medicine, an arm of the influential National Academy of Sciences.

"The public's ability to understand and make informed decisions about their health is a frequently ignored problem that can have a profound impact on individuals' health and the health care system," said Dr. David A. Kindig, a University of Wisconsin professor emeritus of health sciences and chairman of an 11-member panel that wrote the institute's report.

The report suggested that low health literacy is a far broader problem than previously known. Less than a year ago, experts at a forum sponsored by the American Medical Association estimated that 40 million Americans were affected by low health literacy. Yesterday, Dr. John C. Nelson, AMA president-elect, said, "Limited health literacy is a huge obstacle standing between millions of America's patients and the health care they need."

The report urged health professionals to talk to patients in ways they can understand and asked health care systems and schools to incorporate health knowledge into their programs.

Surgeon General Richard H. Carmona said: "Health literacy can save lives, save money and improve the health care and well-being of millions of Americans."

Patients with low health literacy often forgo preventive care and are more likely to be hospitalized or use costly emergency room services, the report said.

The reason, the report said, is that "many people who deal effectively with other aspects of their lives find health information difficult to obtain, understand or use."

The report did not attempt to put a total cost on low health literacy, but it cited three examples of how the problem boosts health care spending:

Inpatient hospital spending for patients with low health literacy was $993 higher than for the average for others.

Inadequate reading skills added at least $29 billion to annual health spending nationwide.

Cultural, educational and language differences between patients and health care professionals contribute to low health literacy, the report said.

The Hartford Courant is a Tribune Publishing newspaper.

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