title: Low health literacy: a barrier to effective patient care.
abstract: BACKGROUND
  Health literacy is defined in the U.S. Department of Health and Human Services initiative Healthy People 2010 as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." It is estimated that 48.8 million Americans are functionally illiterate, making health literacy a major obstacle for providing health care. Although communicating with physicians is a small component of the tasks that are incorporated in a definition of health literacy, it remains the most important aspect of this concept contributing to personal health.
  
  
  METHODS
  Primary care clinics within the Sioux Falls area were provided with both English and Spanish patient education brochures on communicating with physicians. A survey was then distributed to determine how low health literacy was affecting physician practices and what they were doing to remove the obstacles that health literacy presented. Physicians were asked to evaluate the multiple skills and competencies required by patients to access health care services and resources they use to assist patients.
  
  
  RESULTS
  A total of 77 surveys were distributed. Twenty-two (28.6 percent) were returned. Of the physicians who returned the survey, the majority (77 percent) thought that low health literacy is a moderate obstacle in their practices. Several physicians stated that their offices had at least one method in place to assist those with low health literacy, but none of them were using a formal test of health literacy. Only six physicians could name a community resource to assist patients with low health literacy.
  
  
  CONCLUSIONS
  Low health literacy is an unavoidable barrier to effective patient care for physicians across the country. If the full spectrum definition of health literacy is understood by physicians and carefully considered in the context of their own practices, it is likely they would come to the realization that health literacy is a greater obstacle to providing health care than they previously considered. In order to communicate more effectively and better serve our patients, we need to resist stereotyping patients when estimating (e.g., over estimating or under estimating) their health literacy. We also need to identify educational resources and methods of communication that will ease the burden of health illiteracy. With nearly half of patients having low health literacy nationwide, it is essential to understand health literacy and acknowledge this problem in all of our practices.
authors.affiliation: Sioux Falls Family Medicine Residency, Sioux Falls, SD, USA.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Seurer
authors.forename: H Bruce
authors.initials: HB
authors.lastname: Vogt
mesh_terms: D057220:Health Literacy / Q000458:organization & administration*; D006801:Humans; D005791:Patient Care / Q000379:methods*; D010353:Patient Education as Topic / Q000458:organization & administration*; D010817:Physician-Patient Relations; D013023:South Dakota; D011795:Surveys and Questionnaires