Guest Post: Addressing the Correlation Btwn Health Literacy & Mortality In the Elderly

Medication and health management strategies are integral parts of patient care, but if those who need medical help can’t understand their instructions perfectly, the right procedures are lost on them. Health literacy is a growing concern, and it refers to one’s ability to read, process, and implement directions related to personal health care. Both the context of health-related communication and the skill level of health care providers are strong factors in health literacy, but it ultimately describes the comprehension abilities of someone on the receiving end of health care. In a study conducted by Dr. David Baker, MPH, and a team of researchers, it was found that inadequate health literacy contributes significantly to mortality rates among the elderly.

Health Literacy and Mortality Findings

Baker and his team administered a shortened version of the Test of Functional Health Literacy in Adults to a pre-screened cohort of 3,260 Medicare managed-care enrollees. They then collected their data and categorized it into three sections: adequate, marginal, and inadequate health literacy. These results were then compared to all-cause and cause-specific mortality data from the National Death Index, 1997-2003. Although the category of elderly patients with adequate health literacy accounted for the majority of the cohort at 2,094 individuals, their mortality rate averaged only 18.9%. The group with marginal health literacy, which included 366 individuals, averaged a mortality rate of 28.7%, and the group with inadequate health literacy at 800 had a 39.4% mortality rate. Baker and his team found that the number of years of school completed by the subjects was barely associated with mortality, leaving reading and comprehension abilities as the main indicators in determining health literacy. A general lack of health-related knowledge, the ability to apply it, and wide variety of other “pathways” characterized those individuals with inadequate health literacy.

Ways to Address and Manage Health Literacy

According to, a page dedicated to the activities of the U.S. Department of Health and Human Services and other Federal departments and agencies, there are many ways to develop and deliver health information while maintaining awareness of health literacy. For example, information should be appropriate for the user audience and easy to use. It’s also important to speak clearly and listen carefully when communicating health-related information. The following are some strategies that may help pharmacists, doctors, and other health care professionals communicate information clearly to non-professionals and patients.

  • Be sure to identify a specific audience before you draft any health-related communication. Consider demographics, behavior, age, culture, communication capacities, and attitude, choosing materials and messages that address your audience’s characteristics.
  • Evaluate your communication by conducting usability testing. Test users before and after your information is delivered to see how much of it they can understand and repeat back to you.
  • Limit the number of messages you communicate at one time and use plain language that focuses on action. You can include pictures to help demonstrate important steps.
  • Improve the usability of information online. Make sure that patients know how to access the details of what you’re explaining by going to a specific webpage.  Be sure to use large font and uniform navigation to prevent confusion.
  • Ask open-ended questions and ask that your patients repeat the information back to you. You can also request that they act out a medication regimen in front of you before they have to do it on their own.

Baker, David W. et al. “Health Literacy and Mortality Among Elderly Persons.” Archives of Internal Medicine 167.14 (2007): 1503-1509.

Guest Blogger: Alexis Bonari is a freelance writer and blog junkie. She is currently a resident blogger at  First in Education, researching online college degrees. In her spare time, she enjoys square-foot gardening, swimming, and avoiding her laptop.

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