Learning About Adult Literacy: Literacy and Healthcare

As an aside, this is my first post here at Turning Pages as a contributor, and I wanted to begin with the admission that I knew/know little of adult literacy in America. I mean, I have always known that it is a “problem” in the abstract sense: people should have the ability to read, of course. And I could, vaguely, understand the link between social status, economic standing, race, and illiteracy. It made sense, even if I had not put much thought into it.

I found that I exemplify one of the most interesting facets of the adult literacy “situation” in America. We often assume that because someone “functions,” because someone “gets” by in a world driven by reading and writing, by text, that they are literate (in the traditional sense of being able to read English text). But (as I found out during my initial research), this sense of operational contentment sort of breaks down when an illiterate individual has to face some sort of medical emergency or financial trouble. Then, these individuals run into problems with insurance, with prescriptions, and with following treatment instructions. I found that this is not just the case for what I had deemed as “illiterate” adults. In my view, illiteracy meant that you cannot read, Period. But my research has illustrated various forms and ranges of illiteracy. So an individual who gets by with reading particular documents or signs (road signs, for example) can still very easily make a mistake in regards to interpreting healthcare documents and instruction.

I also found that, to a certain extent, the rest of us are allowed to think about it as “their” problem: if they get along, great. If they can’t read, it isn’t a big deal. What does it mean to the rest of us that a small cross-section of our population doesn’t read? We need to complicate this view. Academic Journals such as The Journal of Internal Medicine and The Journal of Learning Disabilities feature articles confronting this issue, with more than one author referring to it as the “crisis of health literacy.”

It goes like this: adults with little or no appreciable skills in reading or writing have continued into advanced age with the help of other parties (a spouse, children, other family friends) who can read. When the support system for some reason is removed from the situation, or when the individual finds themselves confronted by a situation that involves reading or interpreting documents or instructions without the help of others, mistakes are made. In the case of the elderly of those who require intensive medical care, the inability to read instructions or fill out forms is a huge gap: not only does that adult have no way to communicate with the faceless doctor or medical institution behind that document, they may have no way to reach out to others for assistance.

This, in turn, becomes an issue for everyone. The inability of those who cannot read to interact productively with healthcare providers and insurance companies costs the healthcare industry billions of dollars by way of unnecessary emergency treatments. Those who could avoid specific treatments or symptoms often do not when they are unable to read instructions or communicate effectively with their healthcare provider. Furthermore, those with emergency illnesses or injuries who visit emergency rooms often leave with written instructions regarding how to treat wounds, ingest medication, and handle foods and liquids that they cannot read. Inevitably, these people return to the hospital or their doctors for further treatment of the same illness or injury to compensate for their inability to remember or understand their own healthcare documents.

My first questions regarding adult literacy encountered, overwhelmingly, this issue of healthcare. And, obviously and unfortunately, this problem does not go away unless we address both our educating practices for our youth as well as offer services to those who have already entered adulthood without the skills necessary to navigate institutions they rely on for their health and well-being.

This is why organizations such as Turning Pages need support, through donations or volunteers: there are people who want help, who want to learn how to help themselves. But they cannot do it on their own, and more often then not they cannot do it with the support system they have. And it is not just a problem “out there:” adult illiteracy is an issue that affects us all. Educators and tutors with adequate funding and support can commit themselves to helping adults gain the proper skills to be able to go to the hospital, to follow medical instructions, and to take care of their own health and wellness.