Increasing Health Literacy: Expectation versus Reality

By Yash Patel

In early September, Dr. Ranjana Srivastava wrote an article for The Guardian titled, “What’s a uterus? Health illiteracy could be the death of us.” Defined as the extent that patients can acquire and understand health information, health literacy is at an all-time low according to Dr. Srivastava.

In order to be health literate, patients need to access health care service, analyze relative risks and benefits and evaluate information for credibility and quality. With this, they can make appropriate decisions regarding their health. According to American Medical Association, poor health literacy is a stronger predictor of a person’s health than age, income, employment, education level and race. While physicians have expectations for their patients’ health literacy, they are often unmet.

Dr. Srivastava mentions the flaws in her patients, including one unaware of the difference between a spleen and pancreas, and one who is unaware of whether antihypertensives increase or decrease blood pressure. While I might agree that health illiteracy could be the death of us to an extent, Dr. Srivastava provides no solution except the generic line, “Health education must start in school.” I admire that she mentions that education should take into consideration diverse groups of individuals, but in terms of creative solutions she provides none.

Just as physicians would like their patients to be informed of their own condition, so do professionals in other fields towards their clients. I am sure political pundits expect citizens to be aware of all presidential candidates and their platforms in order to make informed decisions. Ideally, citizens would be informed of the nation’s inner workings and of the specificities of their body.

But reality is far from the ideal. Not all citizens are politically aware, and not all patients are health literate. Even though schools can educate students regarding their health, they cannot cover each and every topic to make them entirely informed.

Likewise, students in high schools are not interested in antihypertensives. Advanced Placement and International Baccalaureate courses are not meant to prepare students to communicate with their future physicians. At best, we can teach them the difference between the spleen and the pancreas and test them at the end of the semester.

However, the average student would forget those details after their exams. Ten years later, barely any student would remember the specifics to navigate the complex health care system.

To make matters even worse, an average adult is exposed to the equivalent of 174 newspapers’ worth of information a day, based on 2011 calculations by Dr. Martin Hilbert and his team at the University of Southern California. Moreover, this information is deceptively misleading and contradictory. Just visit a local bookstore and see the amount of dieting books, each relaying a different way to a healthier lifestyle. Based on a 2008 survey by the U.S. Food and Drug Administration, more than 60% of adults agreed with the statement, “There are so many recommendations about healthy ways to eat, it is hard for me to know what to believe”. With so many recommendations around us, making healthcare choices is equally, if not more confusing as finding a new diet.

In the midst of this information overload, more and more adults are turning to their personal or family member’s experiences for guidance. This is why an increasing number of parents are against vaccinations for their children.

Open ended responses on a survey the Pew Research Center conducted in February 2015 pointed to the concept that vaccines for disease are unhealthy for children. “One of my children got a very high fever from immunization,” declared one individual. Another stated, “Honestly, I don’t trust pharmaceutical companies.”

The number of individuals against medical treatment will only increase if  patients continue having subpar relations with their physicians. This can only be remedied with better communication; physicians must clearly explain the relevant medical conditions and treatment plans to their patients.

When inflicted with a disease or condition, an adult is helpless and vulnerable. Likewise, anyone who has tried navigating through the health care system in the United States knows that it is not easy to get the correct information. An added layer of difficulty is present for patients not fluent in English. Most health care professionals are already unable to communicate effectively to English-speaking patients, let alone those with a language barrier.

While more health literacy programs might save the future generation, it is important to focus on the current one. Who is going to provide this generation with a comprehensive health education?

The solution lies in current physicians. While expecting patients to be health literate is idealistic, expecting proper explanations from the physician should be the norm.

At the end of the day, the patient respects their doctor and seeks help. Physicians must take the time to explain the relevant conditions and medications pertaining to their patients, and then follow up with patients to ensure that the information is received properly. This would be the only feasible way to increase health literacy.


Yash Patel is a fourth year human biology major. He can be reached at yrpatel@uci.edu.