Evidence Based Medicine, Literature Review

A healthcare disparity is a limitation of healthcare availability, usually among a certain racial or socioeconomic demographic (Black, 2013). However, there are disparities that don’t have a specific demographic and affect the entirety of the United States, which are potentially most detrimental to the overall health of our country. One of those disparities is health literacy, or the exchange of complex information from the healthcare provider to the patient or client (Black, 2013). The lack of health literacy in America poses as a problem, especially with the chronically ill. Without proper knowledge of how to treat their illness and what to do when the disease process worsens or ameliorates can potentially cause millions of unnecessary hospitalizations,

Health literacy has been demarcated as the measurement of the individual’s capacity to obtain, understand and process simple health information. It is needed to make satisfactory health decisions and determine services needed to treat or prevent illness. Health literacy requires knowledge from many topics, comprising the patient’s own body, appropriate conducts towards healthy results and the difficulties to understand the health system. It is influenced by many conditions such as our communication skills, age, socio-economic status, and cultural background, past experiences, educational level and mental health status (U.S. Department of

Low health literacy has negative health outcomes for many individuals impacted by the unattained health information and teaching that has not been established. Many low literacy individuals do not seek needed treatment due to the cost, unfamiliar location, and the foreign procedures that may occur. Individuals that suffer from low literacy are more prone to the development of chronic disease like diabetes, hypertension, and heart failure.

Health literacy has been a problem with our patients. The most vulnerable populations are the elderly, people with low-income levels, those with limited education, non-native speakers of English, those with chronic mental and physical health conditions, minority, and immigrant populations. Nurses have a great role in helping our patients succeed in understanding their health conditions. Nurses can be of great help in promoting health literacy. Sykes, Wills, Rowlands and Popple (2013) defined health literacy as the ability of individuals to access, understand, appraise, and apply health information. The three domains of health literacy, according to Bennett and Perkins (2012) as adapted from the (WHO) (1998) are functional health literacy, interactive literacy, and critical health literacy. Functional health literacy is basic reading and writing skills to be able to function effectively in a health context. Interactive health literacy is the used of more advanced cognitive and literacy skills to participate in health care. Critical health literacy is the ability to analyze critically and to use information to participate in action, to overcome structural barriers to health (p.14). The U.S. Department of Education published the findings of the National Assessment of Adult Literacy conducted in 2003. The result showed that 36 % of adults have basic or below-basic skills for dealing with health material, 52 %

A big problem today in health care for many people is health literacy. Health literacy is when a person is able to understand and process medical information they are given. Having low health literacy can affect how a person understands, and uses information about their health and health services (Batterham 2016). Low health literacy rates lead to big issues in communication. Limited literacy impacts health behaviors, decisions, and ultimately outcomes. Many people have low health literacy which leads to bad health outcomes. Research shows that low literacy is linked with the lower likelihood of people being able to manage their own health conditions, and less access to health care services which can lead to poor health outcomes. There are many reasons people have low health literacy, A lack of formal education and poor reading ability aren't the only causes of low health literacy. Low health literacy is associated with a number of things like poor engagement in health services, health knowledge, and overall health status. People with low health literacy may feel ashamed and try to hide it from professionals and family members. Most health care professionals are unaware of the level of health literacy their patient has. (Greenhalgh 2015) There is a need to identify individual health literacy needs and address how to work on solutions to benefit them and whole groups of people. Differences in health literacy

Singleton, K., & Krause, E. (2009). Understanding Cultural and Linguistic Barriers to Health Literacy. The Online Journal of Issues in Nursing, 4(3), Retrieved from http://www.nursingworld.org/mainmenucategories/anamarketplace/anaperiodicals/ojin/tableofcontents/vol142009/no3sept09/cultural-and-linguist

Sequist, Cullen, and Acton explain, “American Indians have nearly three times the national unemployment rate, and are less than half as likely to graduate from college” (2011, pp. 1967). With the low education levels that are common amongst this racial group, health care facilities need to make sure they are providing materials and teachings with appropriate fundamental literacy levels. In the book Advancing Health Literacy written by Zarcadoolas, Pleasant, and Greer, the authors describe fundamental literacy as, “The ability to read, write, speak, and work with numbers” (2006, pp. 56-57). As nurses, we need to be aware of others’ fundamental literacy to provide them with a sense of autonomy. If they are able to understand the materials they are reading, then they are able to make confident decisions about their care. In the nursing field, we provide many informational brochures, and are responsible for making sure our patients understand the plan of care. The text provided for our clients should be at an eighth-grade level, or personalized to each patient’s level. Nurses need to make sure they are conversing and explaining with no medical jargon, and allowing time for questions from the

The U.S. Census Bureau currently projects the U.S. population to increase from 319 million to 417 million people between 2014 and 2016.1 Currently, the U.S. Census Bureau’s 2014 National Projections Report has put an emphasis on the rapid growth of the American population due to two factors; change in age structure and the shift of racial and ethnic compositions of the population.1 With a significant growth in the American population, health disparities in regards to race, ethnicity, gender, income and geographical location have risen tremendously, further creating a gap of health literacy.4 This gap in health literacy has created many potential problems in adequate

Literacy is the ability to read and write, and it is based on different competency of individuals. Health literacy is a term that has been used in health literature for more than 35 years. In the United States, health literacy is used to explicate and describe the correlation between patient literacy levels and their ability to adhere with prescribed therapeutic regimens (Ad Hoc Committee on Health Literacy, 1999). Likewise, health literacy is also defined as the grade to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions (IOM, 2004) (U.S. Department of Health and Human Services [HHS], 2000). Health literacy is also influenced by individual literacy skills and individual capacities (Baker, Gazmararian, Sudano & Patterson, 2000). This study is important due to the high number of patients with difficulty interpreting and understanding common prescription drug labelled instructions. It can be inferred that

Only 15-40 % of the population in the U.S. are health literate (Kirk et al. 2012) and 14% of the total adult population have below basic/functional literacy. Of the total adult population with basic health literacy skills, 14 % of the population are men and 16% of the population are

Disparities in health care are significant in the United States and the root causes are multifactorial. Social determinants of health such as poverty, socioeconomic status, access to resources, and patient education influence health outcomes. Emerging data has shown health literacy as a potential contributor to health disparities that impact health and lifestyle choices (Yee, 2017). Health literacy, characterized as a skill set necessary to understand health information, involves communication skills of both patient and health professionals as well as cultural factors. For example, low health literacy has been shown to contribute to health disparities, especially in racial and ethnic minorities (Hill-Briggs, 2012). As a result of an increasingly diverse ethnic/cultural and racial

Health literacy is defined as "The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (Michael K. Paasche-Orlow, 2010), the word Health literacy first appeared in 1974 in a paper which calls for “education standards for all grade school levels in USA” (Carolyn Speros, 2004) . Some recent works suggest that there is a relation between literacy, low health and premature deaths (Christina Zarcadoolas et al, 2005).

“It was estimated in 1998 that between $35-73 billion was wasted in prolonged hospital stays and frequent doctors visits related to low health literacy” (Ickes, MEd & Cottrell, DEd, CHES, 2010, p. 492). With all of the previously mentioned problems of poor health literacy, individuals who fall into these categories are also more likely to die at an early age.

Health literacy is an essential determinant of health. Health literacy is the degree in which people have the ability to obtain process and understand fundamental health services and information in order to make informed health decisions throughout different phases of life. Patients who are better educated and informed about their options and who understand the evidence behind certain methodologies may have better health outcomes. On the other hand, low health literacy leads to many health problems. In fact, it seems to be the “single biggest cause of poor health outcomes” (Kickbusch 208). Low health literacy inhibits self-advocacy in health care settings. Patients with limited literacy cannot actively participate in health-related decisions

Evidence-based practice (EBP) offers a framework utilization of systematic high-quality research, an analysis which consistently enhances measurable client outcome and clinical decision-making grounded in rationality; EBP depends on data collected through experimental research and accounts for individual client characteristics and clinician expertise. The potential benefits of EBP comprise of increased service delivery and quality of care, heightened accountability, and a bridging of the research-practice gap (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000). It is imperative that research scholars are cognizant of research outcome dependability and validity prior to implementing results