MODESTO BEE
ORIGINAL ARTICLE

Last Updated: October 22, 2006, 06:35:24 AM PDT

We're often reminded how many people in our midst are unable to order from a menu or read a book to their 5-year-old. But there's emerging concern about another kind of illiteracy — health illiteracy.

It includes people who cannot read, but also those who struggle with writing and math.

And it includes many who are well educated in other fields, but who are not at all savvy about medical matters, says Nancy Fisher, supervising public health nurse for Stanislaus County.

Medicine has become much more complex than it was just a few years ago. For instance, a diabetic once would watch his or her sugar intake and go to a doctor for tests. Today, diabetics administer theirs own blood tests and insulin, and must consider exercise along with intake of fat as well as sugar.

Californians for Patient Care, an advocacy group, cites studies showing that 42 percent of people don't know what it means to "take medication on an empty stomach." Sixty percent could not read an informed consent document.

Language barriers compound the problem. Experts describe the Spanish-speaking man who was diagnosed with high blood pressure and given two prescriptions, each to be taken once a day. The man, however, read once — 11 in Spanish — and was taking 22 pills a day. His blood pressure was perilously low before a Spanish-speaking medical professional discovered what had happened.

Multiple studies show that people who are able to understand their ailments and prescribed treatments are healthier. The Institute of Medicine has estimated that, nationwide, health illiteracy raises care costs by $29 billion a year.

The campaign to improve health literacy is gaining momentum among professional associations, pharmaceutical and insurance companies, and patient advocacy groups. Proponents place responsibility on providers as well as patients, and say solutions include things as simple as physicians using simpler terms in talking to patients.

Another level of health literacy involves the big-picture developments, such as:

A flu pandemic or avian flu outbreak, or a biological attack by terrorists.

The move toward self-directed care, which forces people to become careful consumers of health care because they are paying out of pocket or out of a limited lump sum allowed under their health coverage. Seniors got a taste of these complicated choices in signing up for their Medicare prescription plan.

Pushes for national and state reform because of spiraling costs. Health care reform has been identified as a top priority by both gubernatorial candidates, so it's essential that Californians understand terms such as "universal care" and the "single-payer system." Californians for Patient Care plans to add a glossary of terms to its Web site (www.calpatientcare.org) early next year, after the reform proposals are introduced.

Literacy is crucial to financial success in our economy; health literacy has life-or-death dimensions. It has to be a high priority, for everyone.