Literacy Linked to Survival in Medicare Patients

July 24, 2007

CHICAGO -- Medicare patients who couldn't read a physician's instructions, or who didn't understand what they read had a higher mortality rate than patients with adequate reading skills.

CHICAGO, July 24 -- Medicare patients who couldn't read a physician's instructions, or who didn't understand what they read had a higher mortality rate than patients with adequate reading skills.

After adjusting for demographics, socioeconomic status, disability, and chronic conditions, patients with inadequate health literacy where 52% more likely to die during an average of 67.8 months of follow-up (P

One possible explanation for the link between reading skills and excess mortality is that patients are unlikely to know a great deal about diseases like hypertension, diabetes, asthma, and heart failure when they can't read the patient education materials.

"Low levels of health literacy are also negatively related to patients' knowledge of human immunodeficiency virus medications and dosing instructions, adherence to the medication regimen, and human immunodeficiency viral load. Use of cancer screening and vaccinations are also lower among people with inadequate health literacy," they wrote.

The authors noted a number of limitations to their studies including the possibility of an unmeasured confounding variable such as cognitive function. Additionally, the short form Test of Functional Health Literacy in Adults is not a comprehensive measure of health literacy and the study was limited to patients who were 65 or older.

Finally, the authors concluded, this study suggests that it may be possible to reduce the excess mortality reported in the study by designing interventions that will deliver needed health care information to patients in ways that will overcome the illiteracy barrier.