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May
2004
Is Our People
Healthy?
Millions of young people will graduate from high school this month,
too many of them unable to balance a checkbook, figure out the
true interest rate on a car loan or find Iraq on a map.
Sadly, many also will be unsure how to comply with a medical prescription,
how to comprehend the risks they so often take and how to interpret
something as simple as a blood pressure reading.
This is not a jeremiad
about the state of education, because it isn’t only schools
that are at fault for a health illiteracy problem that threatens
to retard half a century of biomedical progress.
When it comes to understanding our own health, more than 40 percent
of adults are left behind.
Recent reports from
the Institute of Medicine and the Agency for Healthcare Research
and Quality find that the disconnect between
the language of doctors and the comprehension of even educated
adults is costing the nation billions of dollars in unnecessary
health expenditures. When it comes to illness, people who don’t
get it, get it.
This is vitally important because as people are increasingly expected
to make decisions about health and health care on their own, they
are going to have to be able to understand comparable risks; choose
among drugs, tests and health plans that differ in price, effectiveness
and quality; sign complicated consent forms and make sense of a
blizzard of drug company pitches to make you virile, hairy or continent.
The problem is not limited
to poorly educated Americans, the elderly or non-English-speakers.
Health illiteracy is a complex challenge
because it also has to do with people’s attitudes and fears.
For example, a nationwide Gallup Survey found that half of those
surveyed believe a colonoscopy should be done every year after
age 50, instead of every decade. That striking piece of misinformation
may lead to the fear that causes only half of the respondents at
risk actually having it done.
While 75 percent of women understand the purpose of mammograms,
only 48 percent know that a Pap test screens for cervical cancer.
Thirteen percent of all adult women think it screens for sexually
transmitted disease, ovarian cancer or uterine cancer.
Our nation’s historical
investment in biomedical research and our current annual investment
in healthcare delivery fall short
because the vital link between what we know and improved health
outcomes depends on the ability of people to understand and act
on health information.
There is much to do: using communications research to package
and target information to patient groups with different needs and
skills; enriching K-12 health education nationwide; persuading
doctors to drop their jargon.
These things are not
just nice touches to make health care more patient-friendly.
They are necessary. The federal government spends
$28 billion a year on research to find cures for what costs us
$1.5 trillion to treat. We cannot afford to shortchange this staggering
investment in health just because we can’t decipher the prescription.
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