Clear Answers are Key To Improving Health Outcomes

Have you ever been to the doctor ... 
   and left the office without any idea what he said?  

Have you ever read the instructions on your prescription ... 
   and still not understood how to take it? 

Have you ever avoided asking your doctor to repeat an instruction ... 
   because you were afraid she would question your memory? 

Are you too embarrassed to admit that these things have happened to you?  
   Don't be!

Most Americans struggle with health care information

The ability to understand and use the information about our health conditions is one of the most important self-care skills we can have.  Yet a report from the U.S. Department of Health and Human Services reveals that almost 9 out 10 adults find it difficult to use health information found in clinics, retailers, media and the community.  At least 90 million Americans face some difficulty understanding and acting on information they receive about health care.  


Programs like Living Well, Health Living with Diabetes and Stepping On help older adults take charge of getting - and acting on - the information they need to improve their health.  As workshop participants develop action plans and practice new communication skills, they gain confidence to ask questions of health providers- even when it feels uncomfortable.  And asking questions is key for older adults who have chronic conditions or are caregivers. 


"I think of the doctor, about to leave, with his hand on the doorknob saying 'Any questions?'" says health literacy advocate Steve Sparks.  "Don't give up!"  Sparks advises. "The best time to get the information you need is before you leave the doctor's office." 


Sparks's organization - Wisconsin Health Literacy - is part of a growing national effort to make health care information - from office visits to medication labels - easier for patients to grasp and put into practice. "We all prefer clear communication," Sparks points out. The impact of better health instructions can be dramatic, according to Sparks. "Research shows plain language health instructions lead to fewer hospitalizations, ED readmissions, and fewer adverse drug events for patients with chronic illnesses like heart failure and diabetes."


Poor communication from providers contributes to higher risk for older adults

"Almost everyone will have a problem at some point understanding what they need to know about a health condition or using medication," Sparks says. However, the need to improve communication with older people is especially urgent. "Normal cognitive changes that come with aging can affect people's ability to understand and use health information," Sparks says.  Changes in vision and hearing, as well as medication side-effects, are other challenges for older adults. Nationally, just 3% of adults over 65 have "proficient" health literacy skills, compared with about 12% of all adults - still a shockingly low measure.    


"When I recently spoke to an aging services group, they were genuinely surprised to hear the scope of the problem.  In reality, better health literacy is a shared responsibility," comments Sparks, "but there is much more that providers can do to improve how they communicate with older adults."


Prescription labels are one area where Wisconsin Health Literacy is taking a national leadership role.  New federal guidelines for better prescription labels would especially benefit older adults, who often take multiple medications.  However, the guidelines are voluntary - and very few states have made the switch. 


"We already know that easier to read labels make a difference for people, and lead to better health outcomes," Sparks confirms.  "Wisconsin Health Literacy is now working with UW Health and Hometown Pharmacies to develop a model for successfully transitioning to the new label.  By identifying how that process can work more smoothly, we hope more states will adopt the guidelines - and help consumers get better health care."



What can you do?

Asking questions is key - even if it feels uncomfortable. Sparks says older adults with low health literacy are less likely to ask questions because they may feel ashamed or afraid to ask to have information repeated. He recommends these ideas for improving your health literacy:


1)  Prepare carefully for your healthcare visits.  Know ALL: 

  • Your medications
  • Your health conditions
  • Important procedures you have had, and when you had them 

2) Use the Ask3 framework for your questions: 

  • What is my problem?
  • What do I do?
  • Why is it important? (Remember, understanding why is as important as knowing how, because knowing the reason for an action motivates you to stick to your your health care plan.)

3)  DON'T GIVE UP if you still don't understand!  

  • Don't be shy about asking - and repeating - questions! 
  • It isn't your fault!  Researchers have consistently found that almost all health care information is written and given in ways that most people can't easily understand and follow.
4)  Raise awareness of health literacy risks affecting older adults.
  • Wisconsin Health Literacy offers in-person information sessions and online resources to help community groups improve communication with older adults about health issues.  For more information contact Steve Sparks by phone at 608-257-1655, Ext. 2, or email at