Health Literacy
L. Kari Hironaka
I. Description of the problem/issue: Health literacy is defined as “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”
Health literacy skills can affect one’s ability to navigate through the healthcare system, share pertinent health-related information with medical providers, and engage in self-care and disease management.
The Institute of Medicine has identified health literacy as one of the key factors influencing patient safety, health disparities, and quality improvement.
II. Epidemiology
A. Approximately one of three adults (36%) in the United States have limited health literacy skills.
B. Limited health literacy skills can be divided into “basic” and “below basic.” Examples of “basic” health literacy skills include understanding a growth chart or associating medication administration with food intake. Examples of “below basic” health literacy skills include dosing an over-the-counter medication or reading a clinic appointment card. Individuals with limited health literacy are less likely to obtain health-related information from newspapers, books, magazines, and the Internet. They are more likely to acquire health-related information from TV or radio. Limited literacy skills are often associated with a significant amount of shame and embarrassment.
C. Health-related outcomes
In adults, the relationship between limited health literacy and poorer health outcomes have associated limited literacy skills with the following:
Decreased utilization of preventive health services
Poorer understanding of medical conditions and disease-specific knowledge
Suboptimal self-management skills
Higher rates of hospitalization and emergency department visits
Poorer outcomes for specific chronic conditions
Increased risk of mortality
Limited parental health literacy has been associated with the following:
Decreased health-related knowledge
Decreased disease management for specific chronic conditions
Decreased rates of exclusive breast-feeding
Use of a nonstandardized dosing instrument for measuring liquid medications
D. Specific challenges for pediatric patients
1. Maturation and the developmental change of children over time. Understanding the evolving role and significance of a child’s own health literacy and self management skills on health-related behaviors and outcomes is one of the challenges of assessing the impact of health literacy in the pediatric population. The transition from a child’s complete dependence on a parent to independent decision-making by the adolescent or young adult is a process that evolves over time and varies significantly between different families, individuals, and cultures.
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