Listen to a short summary
Read by
Greg G.
Illiteracy is a big problem in the United States, especially in the Black community. People who can't read well often have worse health outcomes because they can't understand medical instructions. Many Americans struggle with reading, and this can lead to serious health issues and even death. Illiteracy is a major issue that affects many aspects of life, including health and well-being. It is important for communities to provide programs to help people improve their reading skills. Healthcare providers also need to make sure that medical information is easy to understand for everyone, regardless of their reading level. By addressing illiteracy and improving access to education, we can help improve the health of the Black community and reduce the impact of medical illiteracy.
Illiteracy is a silent, but pressing issue in the United States, particularly within the Black community. This problem transcends educational boundaries and has severe implications for public health. “Health Matter’s” introductory article, “Medical Illiteracy: Black America’s Public Health Enemy #1,” outlines the direct correlation between low literacy levels and adverse health outcomes, underscoring an urgent need for systemic intervention.
It is nearly impossible to calculate how many people die each year because they could not correctly read a prescription medicine label or determine the number of patients who became ill after surgery because they could not read or understand critical home care instructions. The Literacy Project has gathered U.S. Census Bureau data to offer a compelling look at illiteracy and the magnitude of the problem:
According to data from The Literacy Project, 45 million Americans are functionally illiterate, unable to read above a fifth-grade level. These statistics reveal the magnitude of the literacy crisis and beg responsible community stakeholders and leaders for a deeper examination of illiteracy’s far-reaching implications. The “face” of illiteracy:
- Currently, 45 million Americans are functionally illiterate and cannot read above a fifth-grade level
- 50% of adults cannot read a book written at an eighth-grade level
- 57% of students failed the California Standards Test in English
- 1/3 of fourth-graders reach the proficient reading level
- 75% of students in California school systems are unable to perform basic reading skills
- 85% of juvenile offenders have problems reading
- 3 out of 5 people in American prisons can’t read
- 3 out of 4 people on welfare can’t read
The early deficiencies in literacy extend into adulthood, contributing to a myriad of social and health problems. These figures are not just numbers; they represent real individuals whose lives and health are severely impacted by their inability to read proficiently.
The financial costs of medical illiteracy are staggering. It is estimated that billions of dollars are spent annually on the treatment of preventable diseases and illnesses suffered by patients who are functionally illiterate. These individuals, unable to read at a fifth-grade level, struggle to understand prescription medicine labels and hospital discharge instructions, which can significantly increase their risk of making medical errors.
This issue is particularly acute among poor, chronically ill individuals who must self-administer their medications and rely on caregivers who may also have limited literacy skills.
Medical content is generally written to be understood by a wide audience, typically at an eighth grade reading level. However, this standard is often too complex for those with lower literacy levels. To illustrate this point, compare the post-surgery care instructions written at eighth-grade, fifth grade, and third-grade reading levels.
The differences in complexity and the ability to comprehend these instructions highlight the challenges faced by those with lower literacy levels. For example, while an eighth-grade level instruction might say, “Limit physical activity,” a third-grade level instruction simplifies this to “You need to rest and get lots of sleep.” Such simplifications are crucial for ensuring that patients can follow essential medical advice.
The impact of illiteracy on health outcomes cannot be overstated. It is nearly impossible to calculate the exact number of people who die each year because they could not correctly read a prescription medicine label or who became ill after surgery due to a misunderstanding of critical home care instructions.
The legacy of historical, systemic barriers to Black literacy, such as laws that made it illegal to teach slaves how to read, continues to wield a profound influence on the health outcomes of African Americans today. These historical injustices have created a legacy of educational inequity that persists in modern times, contributing to the racial health disparities observed in the Black community.
Addressing the root causes of illiteracy in the Black community will require years of sustained, consistent programming to increase access to early childhood and adult reading programs. Church or community-based literacy programs, tailored to address the needs of adults who are poor readers could ease the social stigma of illiteracy.
Healthcare providers must recognize when health literacy may be limited and ensure that medical information is communicated in a manner that is accessible to all patients, regardless of their ability to read and process written care instructions.
Illiteracy is indeed Black America’s public health enemy number one. The inability to read proficiently not only limits educational and economic opportunities but also has dire consequences for health outcomes. By addressing the systemic barriers to literacy and ensuring that medical information is accessible, we can begin to mitigate the impact of medical illiteracy and improve the health and well-being of the Black community.
Jayne Hopson is a 2024 Commonwealth Health Care Performance Fellow. The special series “Illiteracy: Black America’s Public Health Enemy # 1 is funded by Association of Health Care Journalists (AHCJ) and supported by The Commonwealth Fund.