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Senior Citizen Health & Medicine
Senior Citizens with Poor Health Literacy Face
Higher Death Risk
Evidence mounts that reading and understanding basic
information is critical
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Link to video below |
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July 23, 2007 – A new study finds older adults who
cannot read and understand basic health information appear to have
increased mortality rates over a five-year period than other elderly
with adequate health literacy. It joins a long list of studies finding a
major health problem in the lack of health literacy among senior
citizens.
The new study is reported in the July 23 issue of
Archives of Internal Medicine, one of the Archives journals of the
Journal of the American Medical Association.
Previous studies have linked education, as measured
by the number of years of school completed, to longer life, according to
background information in the article. This may be because more
education tends to result in better job opportunities, a higher annual
income and access to housing, food and health insurance, the authors
suggest.
"Another possible mechanism by which education
could exert a direct effect on health is reading fluency," the authors
write.
"The number of years of school completed is
strongly associated with reading fluency. As a result, individuals with
more education tend to have a better capacity to obtain, process and
understand basic health information and services needed to make
appropriate health decisions: i.e., they have higher levels of health
literacy."
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Video:
Many Senior Citizens Risk Medical Errors Due to
Low Health Literacy |
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Difficulty
understanding 'medical speak' found in one-third
of patients
Feb. 12, 2007 – To get
well, you need to follow the doctor's orders.
But, to follow the doctor's orders, you have to
understand them. Senior citizens are the most
likely not to understand medical instructions.
Many other Americans, too, suffer from low
health literacy, or difficulty understanding
"medical speak." This is a problem affecting
more than one-third of patients in the U.S.
health care system. View this video to learn
more.
Click here to watch video. |
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David W. Baker, M.D., M.P.H., of Northwestern
University Feinberg School of Medicine, Chicago, and colleagues
interviewed 3,260 Medicare patients age 65 and older in four
metropolitan areas in 1997, asking questions about demographics and
health.
Participants also completed a test of health
literacy that involved two reading passages and four mathematical items.
Scores range from zero to 100, with zero to 55
designating inadequate health literacy, 56 to 66 indicating marginal
health literacy and 67 to 100 signifying adequate health literacy. The
National Death Index was then used to identify participants who died
through 2003.
Among the participants,
● 2,094 (64.2 percent) had adequate health
literacy,
● 366 (11.2 percent) had marginal health literacy and
● 800 (24.5 percent) had inadequate health literacy.
A total of 815 (25 percent) died during the average
67.8 months of follow-up, including 39.4 percent of those with
inadequate health literacy, 28.7 percent of those with marginal health
literacy and 18.9 percent of those with adequate health literacy.
The results suggesting an increased risk of
mortality associated with inadequate health literacy remained
statistically significant after the researchers factored in
demographics, socioeconomic status, and health behaviors at the
beginning of the study. In contrast, years of school completed were only
weakly associated with death during the study period.
Health literacy was most strongly associated with
death from cardiovascular disease-380 (11.7 percent) of participants
died of this cause during the study, including 19.3 percent of those
with inadequate health literacy and 16.7 percent of those with marginal
health literacy, compared with only 7.9 percent of those with adequate
health literacy.
"Inadequate health literacy is associated with less
knowledge of chronic disease and worse self-management skills for
patients with hypertension, diabetes mellitus, asthma and heart
failure," the authors write.
"Use of cancer screening and vaccinations are also
lower among people with inadequate health literacy. Thus, the
association between health literacy and adverse health outcomes probably
occurs as the result of a wide variety of pathways that have a
cumulative effect."
Recent studies have suggested that it is possible
to improve the health of patients with diabetes and heart failure
despite their low health literacy using targeted interventions.
However, a broader solution is needed, the authors
note. "Most people will have many acute and chronic medical conditions
during their life and face many situations in which they must make
health and health care choices and decisions," they conclude.
"As a result of these myriad demands placed on
patients today, widespread improvements in health and health care
communication will likely be necessary to reduce the association between
health literacy and mortality."
Editor's Note: This study was supported by a
grant from the National Institute on Aging and a Career Development
Award from the Centers for Disease Control and Prevention.
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