Say Ah! and Health Literacy

The Facts: Low health literacy is a hidden epidemic that is a major driver of health care costs and poor health outcomes. The facts presented below illustrate just how wide a gap their is between the average patient and the usability of the health care system. These facts are what made us open our mouths and Say Ah!

  • Nearly nine out of ten adults lack the skills they need to manage their health (National Assessment of Adult Literacy, 2003)
  • Health literacy is a stronger predictor of a person’s health than age, income, employment status, education level, and race (Journal of the American Medical Association [JAMA])
  • Nearly half of American adults are functionally illiterate in dealing with the health care system (JAMA)
  • More than three-quarters of patients do not fully understand the care and discharge instructions they receive in the emergency department (Annals of Emergency Medicine)
  • Two-thirds of American adults age 60 and over have inadequate or marginal literacy skills (JAMA)
  • More than one in three adults in the United States (77 million people) lack a sufficient degree of health literacy to interpret an over-the-counter drug label, or know when a child should receive a vaccine (U.S. Department of Health and Human Services)
  • The cost of low health literacy to the U.S. economy is estimated to be up to $238 billion annually (Low Health Literacy: Implications for National Policy).

The Issues: Low health literacy touches everyone’s life, and nearly every aspect of care. Almost any health or medical story can be written to incorporate issues impacting the


  • Seventy-three billion dollars in federal health care expenditures can be attributed to low health literacy skills, (National Academy on an Aging Society).
  • Studies show that patients forget up to 80% of what their doctor tells them as soon as they leave the office, and nearly 50% of what they do remember is recalled incorrectly(Journal of The Royal Society of Medicine).
  • Only about 50% of patients take medications as directed (Center for Healthcare Strategies).
  • Half of all Medicare/Medicaid recipients read below a fifth-grade level (Center for Health Care Strategies).
  • Low health literacy is linked to higher rates of hospitalization and higher use of expensive emergency services (Agency for Health Care Research and Quality Report).
  • A study of two public hospitals in Atlanta showed that more than a quarter of respondents could not understand when their next appointment was scheduled; 42% did not comprehend instructions to “take medication on an empty stomach;” nearly half could not determine if they were eligible for free care by reading hospital financial aid forms; and 60% could not understand a standard consent form (JAMA).