POSTED ON APRIL 24, 2013:
More than Words
Health literacy about improving care, even happiness
Doctor's office demands might be the surest way for patients to understand their own health needs, according to health literacy researcher Michael Miller.
"The more you understand, the more empowered you are to be able to self-manage your health," said Miller,
He's made it his mission to improve a system that too often leaves patients without a clear understanding of what their doctor tells them.
"I came here five years ago to improve health literacy in the state of Oklahoma," said Miller, an associate professor based in Tulsa with the University of Oklahoma College of Pharmacy.
One example of limited communication comes when picking up a prescription, Miller noted, with few patients having any sort of detailed conversation with a pharmacist.
"That system doesn't reach out and grab you and say, 'Let's talk about this,'" Miller said.
Local health efforts to bolster health literacy include a new health library near doctor's offices at the Schusterman Center Clinic on E. 41st Street. Also, in September, experts in the field convened in Norman for what's believed to be the state's first-ever health literacy conference.
The Oklahoma Health Equity Campaign, a state-backed effort to improve care across socio-economic and racial boundaries, formally recognizes health literacy as a key part of improving care in a state near the bottom in various health rankings.
The campaign cites research linking poor health literacy with a tendency to skip preventive care like mammograms, Pap smears and flu shots. Those with limited health literacy skills also often enter the health care system when sicker than others with better literacy skills, according to research cited by the campaign.
It's also a financial concern, with a higher rate of hospitalization and use of emergency care by those with lower health literacy.
Miller stressed that health literacy is a concern even for otherwise-educated patients.
"We don't train kids at a young age to process this. As an adult, whenever you start interfacing with the health care system, it's kind of a new experience for you," Miller said.
He'd like to spread a message to patients.
"They have to start demanding that they want more information, because the environment's so busy, they're going to get overlooked," Miller said.
After every visit to a doctor, a patient should know answers to three questions, Miller said: "What is my main problem? What do I need to do? And, why is it important for me to do this?"
The concept of health literacy still is an emerging concept, noted Ruth Neal, the research librarian at the new Morningcrest Health Library at the Schusterman Center Clinic.
Her role is to help patients find the information they're looking for in a way that's easily digestible.
COURTESY OFL UNIVERSITY OF OKLAHOMA–TULSA
"I can find out if they prefer a video, or if they prefer print material," Neal said.
By having the library -- the size of a small classroom -- near doctor's offices, physicians can actually "prescribe" patients to visit with Neal to find out more information about their health.
"I'm available to help explain the terminology," Neal said, adding, "If you don't know the word, it's really hard to look it up on the Internet."
Bruce Dart, director of the Tulsa City-County Health Department, said he sees a need to improve health literacy.
"Frankly, I think there isn't a one-size strategy that fits all," Dart said.
He added: "I think context or content should hopefully be accessible to whatever population exists, and should be constructed so there are no barriers to achieving health literacy."
At E. 3rd Street and S. Lewis Avenue, Community Health Connection works with a primarily-Latino population.
"One hundred percent of our dental office is bilingual, 100 percent of our behavioral staff is bilingual, and on the primary care ... either the provider that is providing the medical care is bilingual, or we have a medical assistant who works directly with the provider who is bilingual," said Jim McCarthy, chief executive officer for the clinic.
The language skills are viewed by McCarthy as essential to providing care to this patient population.
"Without this, there's really no way to communicate what their difficulty is, and just as importantly, there's no way for the medical provider to make sure that the patient understands what they must do in order to be better," McCarthy said.
Dart said improving health literacy can't fall solely on the medical provider.
"I don't think it starts and stops with the physician. It's the medical community, the public health community, the education community," Dart said.
Marisa New, director of the health equity and resource opportunities division of the state's Department of Health, said the summit last year helped build bonds between different groups.
"Bringing together those literacy providers together with our health communities, it was huge to have them share information with each other," New said.
Neal said she often refers to an online resource called Medline Plus when helping patrons discover health information.
The library, which opened in October, is open to the public Monday-Friday, from 8am-noon and 1-5pm.
"People can always come back here ... even if it's the next day" after an appointment, Neal said.
Miller has participated in research that even shows health literacy can help people improve their overall happiness.
In Alabama, a group of rheumatoid patients were asked how confident they were in completing medical forms on their own, a question considered to be an indicator of overall health literacy.
"I think this is a reasonably representative sector of the population. It's not something super obscure," Miller said.
Miller and other researchers concluded in their 2010 paper that the connection between health literacy and happiness "might be mediated by a sense of personal control."
Miller said more self-empowerment is needed in the health care system.
"We've got to get patients empowered to want to ask questions, and we've got to create an environment that can actually raise that awareness," he said.
Send all comments and feedback regarding City to firstname.lastname@example.org
URL for this story: http://www.urbantulsa.comhttp://www.urbantulsa.com/gyrobase/Content?oid=oid%3A59291