The Crucial Link between Literacy and Health

Ruth Parker, MD, a practicing internist and researcher at Emory University School of Medicine, was years into her medical career before she discovered the importance of literacy in patient care. The revelation came when she was collaborating with a colleague on research in the early 1990s at Grady Memorial Hospital in Atlanta, Georgia, on waiting times in emergency departments. Much to her surprise, some patients completed the rather long surveys in just a few minutes.

“We began to think, there's no way that you could finish this thing so quickly. And it didn't happen just once or twice, it happened a good many times,” Parker said. Confused, she started reading over the surveys with these patients, and she realized that they weren't reading them at all. Rather, they were just haphazardly answering the multiple-choice questions. Incredulous, she approached a hospital administrator and asked what he thought about the patients' ability to fill out surveys. He estimated that at least half of the hospital's patient could not read.

“I said, ‘How did I get this far and not know this?’ At that point I'd been in the medical field for a long time and taken care of thousands of patients without any idea of how many struggled with very basic literacy tasks,” said Parker. She did a literature search that uncovered only a handful of studies addressing patient literacy in the health care system. When the results of the 1993 National Adult Literacy Survey (NALS) were published, they proved that the Grady hospital administrator's hunch was correct. The survey, the most thorough study on literacy ever conducted in the United States, showed that about half of adult Americans have literacy skills that are limited or even worse—meaning that they struggle to reliably complete many simple daily tasks, such as complete forms, …