Content of Care

The Partnership for Clear Health Communication, an initiative of the NPSF, finds that only 50 percent of all patients take medications as directed, leading to compliance issues and possible negative health outcomes. Additionally, the NPSF finds that adults with low health literacy average 6 percent more hospital visits, remain in the hospital nearly two days longer and have annual healthcare costs four times higher than those with proficient health literacy skills.⁴

Dr. George Isham is medical director and chief health officer of Bloomington, Minn.-based HealthPartners, the nation’s largest nonprofit healthcare organization. He also sits on the board of America’s Health Insurance Plans (AHIP) and chairs the Institute of Medicine’s Roundtable on Health Literacy. Last year, he stated the health illiteracy case thus: “We know that 
90 million Americans have inadequate health literacy and that low health literacy leads to delayed diagnosis, poorer physical and mental health, and increased risk of death.”⁵

The consequences can be deadly. In 2007, Northwestern and Emory Universities conducted a study of 3,260 Medicare managed-care enrollees, one-quarter of whom were deemed medically illiterate. Almost 40 percent of that group died during the study, compared with 19 percent of those who were literate. Factoring in other health-related variables, the study concluded that medically illiterate patients were 50 percent more likely to die.⁶

The negative outcomes are financial, too. The University of Connecticut’s 2007 Low Health Literacy: Implications for National Health Policy study proposes that low health literacy costs the American economy between $106 billion to $236 billion annually. “Our findings suggest that low health literacy exacts enormous costs on both the health system and society, and that current expenditures could be far better directed through a commitment to improving health literacy,” stated John A. Vernon, PhD, the report’s lead author.⁷

The University of Connecticut report’s call for “addressing the low health literacy problem as part of national health reform” was not the first for moving literacy up the health agenda. In its landmark April 2004 report, Health Literacy: A Prescription to End Confusion, the Institute of Medicine identified national attention to health literacy as “critical to successful healthcare.”⁸