Health literacy facts

These statistics were provided by the Center for Health Care Strategies Inc. in Princeton, NJ.

The Costs of Low Health Literacy

The estimated additional health care expenditures due to low health literacy skills are about $73 billion in 1998 health care dollars. This includes an estimated $30 billion for the population that is functionally illiterate and $43 billion for the population that is marginally illiterate. This amount is what Medicare is expected to pay to finance physician services, dental services, home health care, prescription drugs, and nursing home care combined.

Medicare pays 39% of the expenditures. Most of the additional expenditure is financed through FICA taxes on workers. Employers may be financing as much as 17% of the additional health care expenditures due to low health literacy skills. Among adults who stayed overnight in a hospital in 1994, those with low health literacy skills averaged 6% more hospital visits and stayed in the hospital nearly two days longer than adults with higher health literacy skills.

Understanding Medical Information

Only about 50% of all patients take medications as directed. Among the elderly, compliance often drops below this level. Patients who read poorly have even more difficulty complying with their recommended treatments. Of 2,659 patients in two urban public hospitals, those with inadequate health literacy were five times more likely to misinterpret their prescriptions than patients with adequate reading skills. Of 177 older adults living in public housing, 25% said they had difficulty reading written information given to them by doctors.

Among patients with low health literacy:

  • 81% could not read the rights and responsibilities section of a Medicaid application.
  • 74% did not know if they were eligible for free care.

Poor health literacy has legal ramifications:

  • Recent court decisions suggest that merely handing a patient a consent form to sign does not satisfy a provider’s legal obligation to get informed consent.
  • A patient with poor reading skills has a legal right to receive verbal information about the risks, benefits, and alternatives to a proposed procedure.