Health Literacy: Why It’s Crucial for Parents (and Everyone!)
by: Jennie duMonde CD(DONA)
Picture yourself for a moment in a paper gown sitting in a drafty, unfamiliar room. Does this sound like an ideal setting to process information about your body—or your life? I have a good reason for beginning with this unpleasant imagery, but now gently move yourself onto the white sands of a beautiful beach and continue reading.
Health literacy is an issue that affects each and every person on the planet…but what does that term really mean? In my career as a birth doula, I am pleased to be a part of the process an expectant family goes through in their preparations for a new baby. Throughout both pregnancy and labor, I use comfort, reassurance, and resources to explain and provide perspective in the least intrusive yet most helpful manner. However, when I take a step back, I realize that I’m part of a larger movement, where people seek to empower themselves with information in order to get a more complete picture.
Health literacy is commonly defined as a person’s ability to access, understand, and process medical information and services, in order to make the best and most appropriate medical decision. But challenges to success with this concept abound. For example, language barriers, limited computer access, complex terminology, and especially the way a doctor presents information can all affect a person’s comprehension. Fatigue, distraction, stress, emotions (such as fear), certain medications, and illness can also interfere with understanding.
I recently spoke with one of my favorite health-literacy proponents, Dr. Gordon Heinrichs, DC, who also happens to be my dad. :^) He personally realized his own great need in this area during a routine physical exam, when his doctor casually mentioned that he had some major health abnormalities that would require extensive and immediate treatment. To say this was a shock to him is a major understatement! I am immensely happy and grateful to report that my dad is healthy again and working hard to shed light on this undervalued subject.
And speaking of value, research has shown that low health literacy means loads of wasted money, costing the U.S. between $100 and $200 billion each year. Ignoring this vital topic results in more hospital and emergency room visits/re-admissions, disregard of medication instructions, neglect of preventative health measures (good nutrition, breast exams, quitting smoking, etc.), and poorer health in general.
However, Dr. Heinrichs and other health-literacy advocates are not only attempting to spread awareness to patients, they’re also approaching this situation from another angle: the doctors. The aim is to convince practitioners to present up-to-date information in the most basic way, and then check to see if the patient understood what was conveyed. This is called the Teach-Back Method, where doctors ask open-ended questions to confirm understanding. Their presentation should help motivate the patient to desire to grasp the facts. Additionally, many insurance companies are rewriting their medical forms and documents, translating them into language that is “simple and easy to understand.” (Visit plainlanguage.gov.)
According to Dr. Heinrichs, the bottom line (and the overarching problem) is that a person can’t really prepare for everything. But there’s good news! We don’t have to sit idly by, waiting for the system to change—there are steps we can take right away to improve our footing.
When you see your doctor, one of the best things you can do is bring a companion. This is someone who will support you, remind you about questions, write down answers, and help explain and sort through the visit afterward.
You can also bring a list of questions to ask. Composing this list while you are calm and undistracted will ensure that nothing will be forgotten. And when scheduling your appointment, it may also be a good idea to mention that you’d like to spend a few extra minutes with the doctor to prevent a rushed meeting.
After asking your questions, confirm your understanding. We can initiate communication that requires more than just a one-word answer by using phrases like, “Doctor, what I understood you to say was…” and then asking for clarification.
If you have prescriptions, bring a list of current medications to fully inform the doctor. And on a side note, be aware—sometimes a medicine’s effects can be so incredibly subtle that we don’t even perceive that we’re not thinking clearly.
Do some reading. Some helpful books Dr. Heinrichs suggests perusing are The Essential Patient Handbook and Worst Pills, Best Pills. Both of these are found easily on Amazon.com and offer lots of useful information that will benefit any patient.
And finally, discuss health literacy with others. My dad had been working in the health-care industry for decades when his crisis occurred, and he was astounded by his own low health literacy. We need to change our culture in order to help others.
The truth is, out of 11 industrialized countries that were studied by The Commonwealth Fund, the U.S. is at the very top of the list for health-care spending, but ranks last when it comes to overall health care (search for “mirror” at commonwealthfund.org). This news is sad and startling, but my hope is that it motivates us to better manage our health-care experience. Never before has information been changing so quickly, and there is some momentum in this area as people are recognizing the need to improve the plight of the patient and initiatives are being created to correct our course.
Dr. Heinrichs reasons that small misunderstandings can lead to big problems, especially in this area. Fortunately, we are not helpless. Take charge of your health and the health of your family! And to have a larger impact, talk to others about health literacy to increase awareness. You’ll be glad you did!