When it comes to our health care, how much do we really understand? Consider the following scenarios:

The neurosurgeon gives you a diagnosis. All you hear is the word "tumor." Everything after that is a blur, so you miss the word "benign."

Your mother has been prescribed a dozen different medications. You find out that she's dumped them all in a candy dish and is taking the ones that look important.

Your grandfather doesn't speak much English but refuses to bring an interpreter to his doctor's appointment. The doctor can't get him to understand the importance of a colonoscopy, so it's up to you to explain it.

These types of scenes play out every day across the United States. Why? Because nearly half of our adult population has low health literacy. Patients with low health literacy are less likely to comply with treatment and seek preventive care, and they're more likely to be hospitalized.

What is health literacy?

When you are health literate, you have the ability to understand and use written health-related information in order to make good health care decisions. If you are health illiterate, your health and wellness may be at risk. Regardless of your level of health literacy, if you're faced with complex medical information and treatment decisions, it can be very difficult to make sense of it all. Being health literate means the ability to:

  • Locate and evaluate health information
  • Analyze relative risks and benefits
  • Calculate dosages
  • Interpret test results

Any one of those things can be hard--they're even harder when you're trying to do it for your sick child, aging parent or suffering spouse. At some point, we're all health illiterate. If we're upset, tired or angry, our reading and listening comprehension skills are compromised. We're also health illiterate when we don't understand the language in a foreign country.

Ellen, a grade school teacher, was on vacation in Mexico when she discovered the meaning of health literacy. During a snorkeling expedition, she stepped on a sea urchin, and a spiny barb was buried deep into her heel. "I was in so much pain, I couldn't think straight," she says. "I finally got a taxi to a doctor's office in town. Fortunately, I could just point at the spine and he could get to work cutting it out. But I couldn't tell him which painkillers I'm allergic to. I couldn't remember their names, and there's no way I could translate them into Spanish. So when he offered me some, I had to say no. It was horrible."

Health care and comprehension

Another hurdle is that a lot of health care information is written--and not everyone can read it. The average adult in the U.S. reads at an eighth-grade level. But many studies show that health information is usually written well above the average reading level. That means most patients won't be able to understand the educational handouts, consent forms or medical history questionnaires. And without that information, they could receive less-than-optimum care.

The use of jargon can also cause confusion. Jargon refers to words, phrases, or concepts that are unfamiliar and misunderstood by most people. Medical jargon includes:

  • Overly technical terms (like hypertension instead of high blood pressure)
  • Unfamiliar acronyms, such as COPD or GERD
  • Concepts, such as referral or follow-up, that mean something very specific in health care

Being health literate isn't just about reading, either. In order to understand most health care information, you also need to be:

  • Visually literate (able to understand graphs, charts or diagrams)
  • Computer literate (able to operate a computer or smart phone)
  • Information literate (able to learn, retain and apply relevant information)
  • Numerically literate (able to calculate or make decisions based on numbers)

Who's at risk?

According to the National Network of Libraries of Medicine (NN/LM), more than two-thirds of adults over age 60 have inadequate health literacy skills, and 81 percent of patients age 60 and older at a public hospital can't read or understand basic materials such as prescription labels. Minority and immigrant populations are also at risk, as well as those with low income and chronic mental or physical health conditions.

What you can do

The federal government is making a national effort to make health information more straightforward and understandable. While those initiatives will have an impact in the future, there are some things you can do right now to increase your health literacy:

  • Ask questions. Make sure you get the answers you need. If you don't understand, ask the doctor or nurse for more information.
  • Be prepared. Before you see a doctor, find out what's involved in a course of care, and take a list of questions to ask once you're there.
  • Repeat information. After your doctor or nurse gives you directions, repeat those instructions in your own words. Simply say, "Let me see if I understand this." This gives you a chance to clarify what you know--and what you don't.
  • Bring your medicines. Ask your doctor to go over all of your drugs and supplements, including vitamins and herbal medicines. Make sure you understand potential interactions and side effects.
  • Have someone go with you. Bring a friend or family member to help you understand what the doctor is saying, especially if you expect to receive important or potentially scary information.
  • Get an interpreter. You have a right to an interpreter at your doctor's office or in the hospital, at no cost to you. Even if you speak some English, tell the doctor's office what language you prefer when you make an appointment. You can also use Provider Search to find a doctor who speaks a different language.

Get more information about health literacy from the Centers for Disease Control and Prevention and the National Network of Libraries of Medicine.


Lisa Cannon

Lisa Cannon has been a writer and editor for nearly 20 years. She writes about everything from the health benefits of journal writing to the best ways to recycle computer hardware. She lives in beautiful Portland, Ore.