Health Literacy - Do You Get It?

Health literacy. Health care buzzwords of 2013. Two words that can make a grown adult feel like a child. The elephant in the room. How do I explain health literacy without making people feel like idiots? Life gave me an example.

Last week I needed to have my internet provider send over a technician to troubleshoot some crazy problems I was having with email. I’m not new to computers or the internet, having bought my first machine in 1987, but I didn’t understand why more than a thousand emails that I had deleted weeks, months and years ago were reappearing in my inbox. The technician arrived with a trainee in tow. I described my problem for what seemed like the millionth time. The technician turned and looked at his trainee and explained what they’d be doing to check my signal strength, modem and router. I had no idea what they were talking about. I know what a modem does. I know what a router does. I installed both of them. But I had no idea what these two young men were talking about, didn’t understand what those numbers and graphs on their laptops were telling them, and I could guide them no further about my situation, never mind try to decide the next course of action. Clearly my computer literacy level was not as great as I thought it was. I felt pretty dumb, pretty computer illiterate, so I went and sat on the couch with my dog and let the guys do what they do.

Translate that experience to your own health care situation. You’ve owned your body your whole life, and you have a kind of communication going with it. One day your body tells you that you’re not feeling well, maybe starts a cough and fever and sends up an urge for chicken soup. So you call your health care provider and explain your problem in order to get an appointment. Then you go to the office and explain your problem again to the person who has the machines that measure your weight, vital signs and oxygen level. Then you get to see the provider and explain it all over again. Maybe they’re paying attention, maybe not. Maybe you’re giving all the information they need, maybe not.  All you know is that, when the provider starts explaining what may be going on, what tests you’ll need, and how you should take your medicine and take care of yourself, you’re suddenly lost in a language you don’t quite understand (“medicalese”) and you start to rely on faith that whatever that person told you is the best thing for you to do. You stop participating in the process, just as I did with the computer technicians, and you step aside and let the providers do what they do. And that’s just wrong.

Enter 2013 and health literacy. Today we’re telling you that you own your body, and you’re empowered to make all the decisions about it – but no one explains just how you’re supposed to do that! How do you know if you have the information you need and that you’re processing it correctly so that you can make decisions about your health? You probably don’t. Many millions of Americans have basic literacy issues to begin with, which means they can only read at or below the 5^th grade level. When it comes to health literacy, it’s not only those with low basic literacy levels who run into trouble; even a person with a PhD in rocket science can be completely baffled by what’s going on with their body. Anyone can have low health literacy. So don’t feel ashamed if your provider is speaking a language you don’t understand, because that’s exactly what’s happening – and it’s happening to many millions of people. Health care has a language and a culture all its own. It’s a club, and you don’t get to know the secret handshake. But we expect you to understand what we’re saying and to make decisions about your health. We expect you to understand your own anatomy, physiology, pathophysiology, pharmacology, mathematics  and all kinds of special topics that are second nature to us - but that are totally foreign to you. 

There’s hope. Don’t go sit on the couch with your dog. In my next post I’ll explain what we’re doing to help you understand - so that you can make decisions with confidence.  It can be done!