Illiteracy__A healthcare issue

Illiteracy__A healthcare issue


The Silent Epidemic — The Health Effects of Illiteracy
Erin N. Marcus, M.D., M.P.H.
Copyright © 2006 Massachusetts Medical Society. All rights reserved.
n engl j med 355;4 July 27, 2006
Downloaded from on July 31, 2006 .
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Part A
A patient reported to a clinic for a tune up, but had not taken his cardiac or diabetes medication. The patient was then instructed by the new physician on how to take the medication using simple English. The patient agreed to take the medication, but when reporting again the patient had irregular records for his diabetes. The student who saw him first suspected that the patient was illiterate.

Part B
Patients with reading problems my avoid outpatient doctors because of the paperwork and reading involved. A&E departments are user-friendly for illiterate patients because others do the necessary paper work. Shame and guilt might be associated with illiteracy and people are reluctant to mention their problem.

The relationship between illiteracy and health is still unclear, but illiterate people are more likely to report ill health. Doctors using simple and jargon free language might not be enough.

Part C
Routine screen for illiteracy might create problems for the health care sector: takes too long, embarrasses people and might stigmatise patients. An in an era of “Pay for Performance” model, illiterate people might be excluded or not given the right attention they need.

- 14% of adults in the
USA have below basic level of prose literacy.
SEE ARTICLE for details and more statistics.

Language Issues:
- Is there a fundamental difference between spoken language and written language for the human mind?
- Could it be that spoken language is the minimum language skills one needs to survive? Does this hold true in a society that depends on reading skills like ours?
- Can a human being survive in a society without any language skills at all and unaided by anyone? Is this the same situation for immigrants in a country where they do not speak the local language?
- What are the differences between an illiterate person and an immigrant who does not speak/read the local language?

- One of the issues which this article identifies is that there are no solutions that have been fully tested, i.e. scientifically confirmed, presumably to medical standards, although some studies do identify one possible solution or another. Maybe the problem is not one of science, as such, but judgement and common sense might be more useful in these situations.
- just because some solutions cannot be tested scientifically it does not mean that the solution is not valid or the right solution. For example, healthcare budgets are not arrived by scientific testing nor value judgments about what is the right thing to do.
- who is responsible for illiteracy in our society? Society itself for stigmatising it and maybe prevent people from discussing their problem? Or the individual for not fully preparing themselves to live and function in our society?

Can we afford illiteracy today?

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