“She had a temperature of 101.4,” the child’s mother told me in the ER. When I asked if that was the highest it had gotten, she replied “Oh no, it got as high as 100.8.”
As I considered how to respond, the father slowly interjected, “Wait a minute, 101.4 is higher than 100.8.”
Mom could scarcely contain her scorn. “No it isn’t,” she sneered. Turning to me for validation, she said “101.4 is not higher than 100.8,right?”
“Actually, he’s right, 101.4 is higher,” I said gently, prompting a satisfied smile from the father and a look of incredulity from the mother.
At the time I found this amusing. But lack of health literacy and numeracy is both common and concerning. According to a 2006 report, only 12% of Americans are sufficiently proficient in health literacy, lagging most of the rest of the industrialized world. Poor health literacy interferes with the ability of people to manage their own health, and undermines efforts to improve patient-centered decision making.
October is Health Literacy Month, underscoring efforts by individuals and organizations to raise awareness of the issue and spur improvements. An example I learned about recently: Children’s Hospital of Philadelphia is opening the South Philadelphia Community Health and Literacy Center, which will bring together clinics, a recreation center, and a library to address a variety of community needs. It will include a Consumer Health Resource Center targeting health literacy needs.
As providers there is much we can do as well:
- Use “teach back” when educating patients and families to check for understanding and identify additional learning needs
- Rather than asking “Do you have any questions?” end with “What questions to you have?”, thus normalizing the questioning process
- Augment numbers with simple graphs to illustrate numeric concepts – these are more intuitive than percentages, for example
Improving health literacy is integral to our work as care providers. After all, the word doctor comes from the Latin docere, meaning to teach. And nurse comes from nutricia which meant, among other things, a female tutor. Now if only I could figure out this new math….