Health Literacy: A Prescription to End Confusion

More than one-third of American adults lack sufficient health literacy to effectively navigate medical treatments and preventive health care.

Health literacy, as defined by the Institute of Medicine, is the ability to access, process, and understand basic health information and services needed to make appropriate health decisions and follow treatment instructions.

Inadequate health literacy is more common in certain demographic groups (e.g., older adults, individuals with limited financial resources, and those who did not complete high school). However, research shows that even highly literate, well-educated individuals may struggle to understand information provided by clinicians.

Health Literacy Is the Law

Providing easy-to-understand health information is not just best practice, it is a legal responsibility. The Joint Commission mandates that healthcare providers ensure informed consent documents, medication instructions, discharge plans, and other communications are clear and understandable to patients.

U.S. courts consistently affirm that medical providers have a duty to help patients understand their diagnoses and treatments. Common communication breakdowns that have led to malpractice lawsuits include:

• Inadequate explanation of diagnoses or treatments
• Patients feeling ignored or rushed
• Clinicians dismissing or failing to understand patients’ perspectives

What You Need to Know

Health literacy is not directly regulated by a single law in the U.S., but several federal laws and regulations require healthcare organizations to ensure patients can understand and act on health information. These policies promote equity, safety, and informed care.

Affordable Care Act (ACA)

• Section 1557: Requires language access (interpreters & translated materials) for patients with limited English proficiency (LEP).
• Sections 3501 & 5301: Promote use of health literacy strategies to improve quality and reduce disparities.

Title VI of the Civil Rights Act (1964)

• Prohibits discrimination based on national origin—requires meaningful access for LEP patients.

Joint Commission & NCQA Standards

• Accreditation bodies expect:
  • Clear communication practices
  • Patient-friendly education materials
  • Informed consent that meets literacy and language needs

6 Ways to Improve Patient Communication

(From the AMA Foundation’s “Health Literacy and Patient Safety: Help Patients Understand”)

1. Slow Down

Improve communication by speaking slowly and spending a little extra time with each patient. Encourage questions, sit rather than stand, and ask patients to explain their understanding. Use plain, non-medical language, sometimes called “living room language”:

• Annually → Yearly
• Arthritis → Pain in joints
• Cardiovascular → Having to do with the heart
• Dermatologist → Skin doctor
• Diabetes → High blood sugar

2. Show or Draw Pictures

Simple visuals and instructional videos, combined with verbal and written instructions, can help patients better understand their care.

3. Limit and Repeat Key Information

Focus on a few key messages per visit and repeat them. Written materials should be at a 6th-grade reading level or lower.

4. Use the “Teach-Back” Method

“Teach-back” involves asking patients to repeat back in their words what you have told them. Instead of asking a patient, “Do you understand?” try this: “I want to make sure I have explained this clearly.

5. Create a Shame-Free Environment

Consider using the Ask-Me-3 program which encourages patients to ask (and medical providers to answer) three questions at each medical encounter.

• What is my main problem?
• What do I need to do (about the problem)?
• Why is it important for me to do this?

6. Translate, Test, and Tailor Information

Use readability tools, provide translated handouts, or work with a qualified interpreter for patients who are not fluent in English. If you are bilingual and wish to communicate directly with your patient, ensure you are credentialed as a Qualified Bilingual Staff (QBS) member with Revere Medical. For more information, review the BCSLA support article or contact bcsla@reveremedical.com.

Scope of the Problem

A review of multiple studies regarding health literacy found that,

• 26% of patients couldn’t read their appointment slips
• 42% of patients didn’t understand prescription labels
• 48% of patients didn’t understand “take every 6 hours”
• 42% of patients didn’t understand “take on an empty stomach”
• Up to 78% of patients misinterpreted warning labels
  (Kendin, 2006)

What someone with low health literacy might see:

“Your naicisyjp has dednemmocer that you have a ypocsonoloc. Ypocsonoloc is a test for noloc recnac. It sevlovni gnitresni a elbixelf gniweiv epocs into your mutcer. You must drink a laiceps diuqil the thgin erofeb the noitanimaxe to maelc out you noloc.”(Weiss, 2007)

Commemorating Helen Keller June 24–30

Helen Adams Keller was born on June 27, 1880, in Tuscumbia, Alabama. She lost her sight and hearing at 19 months due to an illness believed to be scarlet fever. Her teacher, Anne Sullivan, from the Perkins Institute for the Blind, taught her to use Braille and hand signals—tools that empowered Keller to communicate and connect with the world around her.

Interested in learning more?  Watch this short video on YouTube to see Helen Keller communicate and speak.