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Addressing hidden health illiteracy

Klots gshur 4 spo shiurf; po juvne weemps wism: Imagine if that's about as much sense as you could make of the label on your prescription bottle. Unfortunately, this isn't an imaginary situation for a significant number of patients.

Illiteracy is a broad social problem, but its role in health care is often overlooked. "Health literacy" is considered the ability to read, understand, and act on health-care information, and as many as 45% of adults in the United States may not meet this standard. That gap can lead to misunderstood medication or dietary instructions and result in poor health outcomes.

At Dartmouth, the Area Health Education Center (AHEC) is addressing the issue. The mission of AHEC, a federally funded initiative, is "to improve access to health care, especially in underserved and rural areas," according to Rosemary Orgren, Ph.D., the program's director. The northern New Hampshire branch of AHEC held a conference a few months ago to teach health-care providers how to improve their communication skills. Anne Conner, an AHEC outreach librarian, says patients with health literacy problems can "have difficulty following recommended treatments or keeping appointments." They also may not know the names of medications they have taken for a long time or may need help filling out forms.

Conner describes a few of the strategies recommended in the AHEC conference. When handing out written materials, she says, providers should ask questions that require patients to find information on the page. If need be, they can review the materials and emphasize key points. "They might highlight or circle the most important information," Conner says. Giving patients an audiotape with the information they need can be helpful in important cases. Conner notes that her office also offers to evaluate the reading level of any health materials.

Illiteracy can be very embarrassing, she explains, so much so that people often won't admit to having a problem reading, even to their own spouses—or doctors.


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