One of the best parts of being a parent is re-experiencing the world through your child’s eyes. Although, some of those childhood experiences aren’t all wonder and joy.
On a recent family trip to the museum, Oliver became more and more irritable, and it was clear he was beginning to come down with something. As I sat with him to see if I could find the root of the pain, it quickly became clear he had developed a disease that I dreaded as a child: pinkeye. We promptly headed for the exit and called the nurse hotline at his pediatrician’s office.
We talked through his symptoms with the nurse and came to the consensus that Oliver indeed had pinkeye, and with a few antibiotic eye drops a day he’d be back to normal. Later that afternoon, while picking up the prescription at my neighborhood pharmacy, I was amazed at how quick and easy my health care system encounter had been. Just a quick call, a few hours wait, and a filled prescription—Oliver was on his way to being healthy again. What’s all this fuss about difficulty navigating the health care system?
But when I got home and read the medication instructions, I was confused at what my next steps should be. Our nurse had said to give Oliver the eye drop medication three times a day for either a week or at least two days after symptoms disappear, whichever came first. The pharmacist had said two drops a day for a week. When I read the instructions on the prescription—five drops a day for at least a week—I was at a loss for exactly how many drops to administer and for how long.
Considering I have the benefit of years of experience working in the health care sector, and am well educated and highly literate, it was eye-opening (pun not intended) to see how easily I could find myself unable to make appropriate health decisions. And my experience was far from an isolated occurrence. Health literacy—or the capacity to obtain, process, and understand basic health information and services to make appropriate health decisions—is out of reach for many Americans. According to the most recent data (PDF), a majority of adults in the United States have at least intermediate health literacy. But a full 14 percent have a below basic health literacy level and, importantly, these percentages are not shared proportionally across all populations. Indeed, health literacy statistics mirror other major health outcomes in their stark disparities across race, income, educational attainment, and other social factors.
With recent expansions in health insurance coverage, we should pay particularly close attention to health literacy among the newly insured. The disparities in health literacy between those with private insurance and those who are uninsured or enrolled in Medicare or Medicaid is striking. Local innovations like Project SHINE and consumer education checklists are important steps toward decreasing these disparities, but there is still a lot of work to be done, including improving health systems so all players have consistent communication and instruction.
A few days into my daily struggle of administering Oliver’s eye drops, I realized that my goal was simply to get the medication into his eyes as many times as he would let me, which turned out to be not that many. However, 2-year-old issues aside, it’s important that we strive to reduce confusion and lower barriers to health literacy for all Coloradans—and especially vulnerable Coloradans—through patient activation, systems improvement, and care coordination.