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Study: Low health literacy takes financial toll on state

by Carolyn Pennington - November 13, 2006

Fifteen percent of Connecticut residents have low health literacy, and it is costing the state more than six billion dollars a year in additional health care expenses, according to a new report by the University's graduate program in public health.

Health literacy refers to a person's ability to acquire, understand, and use health information and services in order to make appropriate health decisions.

Details of the report and recommendations on how to improve the state's health literacy were released during a recent forum at the Legislative Office Building in Hartford.

"People with low health literacy face greater risk of unnecessary illness, disability, and even death," says Christine Torres, a graduate student in public health, one of 17 students who worked on the report.

Low health literacy can cause people to make errors in using medication or following self-care instructions.

Caregivers may falsely presume an individual is non-compliant with treatment recommendations when, in fact, poor health literacy is the underlying problem.

"One in five people reads at or below a fifth-grade level," says graduate student Kimberly Lewendon.

"Most health care materials are written for someone who reads at a tenth-grade level, suggesting that much of the health care material given to patients is written at a level too advanced for them to fully understand."

Since people often don't question what they don't understand, health providers may believe the health literacy of their patients is higher than it actually is, she adds.

The consequences for the community are also substantial.

Because of low health literacy, conditions that could have been prevented or treated at an early stage often require complicated, extended care at higher cost, placing an additional burden on an already overburdened health care system.

The cost of care for people with low health literacy is believed to be four times the cost of care for the general population.

"There would be considerable health care savings if health literacy were improved," says graduate student Annamarie Beaulieu.

"Investing upfront in patient and provider health literacy education will ultimately be more cost-effective, by reducing the expense of repeat treatments and delayed, more invasive, and costly health care."

Beaulieu says that through efforts to limit misdirected or excessive use of health care services, expenditures can be focused on those in greatest need.

The public health graduate students who wrote the report worked alongside and in partnership with more than 130 community-based organizations across Connecticut.

The report offers recommendations for programs and activities to improve health literacy.

To increase the effectiveness of health education materials, it recommends writing them at a sixth-grade or lower reading level, in clear, concise language, and with pictures or illustrations.

Although some health professional schools are starting to incorporate direct health literacy training into their curriculum, others have not begun to address it.

The report says health literacy needs to be introduced into formal training programs for allied health professionals, who often direct and sustained contact with patients.

It should also be formally introduced and reinforced throughout the academic careers of master's and doctoral level medical and health care professionals.

Other recommendations include raising awareness through regional conferences and workshops, and establishing a health literacy task force to help determine further recommendations for the governor, legislature, and state departments.

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