Why should a devoted mother so misunderstand a doctor's instructions? This illustrates a widespread problem: poor health literacy.
"It is neither just, nor fair, to expect a patient to make appropriate health decisions and safely manage his/her care without first understanding the information needed to do so," declares the book Reducing the Risk by Designing a Safer, Shame-Free Health Care Environment.
In the United States, we spend the most in the world on health care - more than $8,000 per person. And yet, the World Health Organization in 2000 ranked the U.S. system 37th in overall performance, and 72d by overall level of health (among 191 nations studied).
Many factors are involved. One rarely mentioned is poor health literacy.
The government's standard of care, Healthy People 2010, defines health literacy as having three components. A patient must be able to obtain, process, and understand basic health information and services; make appropriate decisions; and access/navigate the system.
It's shocking how often this fails to happen. Take the mother who recently brought her 3-year-old son in for a follow-up visit from an asthma hospitalization that almost killed him.
In reviewing his drugs, his mother was confused about which medicine was his "daily" controller (Flovent) and which was his rescue medicine (Albuterol). She also didn't understand why he needed medications every day if he was "all better now."
This is no isolated predicament. Childhood asthma rates in Philadelphia are nearly double the national rate, affecting more than 20 percent of the city's children.
And yet 78 million Americans have less than a basic health literacy, aka a sixth-grade level.
In asthma, low parental health literacy leads to 4.6 times more hospitalizations, 1.4 times more ER visits, and 2.8 times more missed school days than healthier children.
