A substantial number of millennial and Gen X Americans have trouble reading a pill bottle, research out today suggests.
Scientists at Northwestern University in Chicago tested the health literacy of primary care patients between their 30s and 50s. Roughly a third scored poorly on the test, while many struggled at everyday health-related tasks like choosing a medication’s correct dosage or remembering a doctor’s instructions. The findings indicate that more should be done to improve people’s comprehension of their medical needs, the researchers say.
“This is less about what any individual can or cannot do and more about how the healthcare system can better support people in managing increasingly complex health demands,” lead author Abigail Vogeley, a research fellow and neuropsychology doctoral student at Northwestern University Feinberg School of Medicine, told Gizmodo. “If you’ve ever left a doctor’s office unsure about what you were supposed to do next, you’re not alone.”
A missing gap
Studies have consistently shown a majority of older adults struggle with health literacy, and the worse your health literacy is, the poorer your health tends to be. That’s an alarming issue since these same people typically rely on many medications to take care of their various medical conditions.
According to the researchers, however, there’s been less attention paid to how literate younger Americans are about their health. So the team began a long-term study, known as the MidCog project, to look at how health literacy and other factors are affecting middle-aged Americans as they get older. It involved roughly 1,000 people who had recently scheduled a visit to a Chicago-area medical center or hospital (either in the past year prior to the study or in the six months after enrollment).
“Our team started investigating this earlier in midlife for several reasons. Middle age is when health problems and chronic conditions like high blood pressure, diabetes, and high cholesterol start to first appear. This time of life is also when the lifestyle habits people carry into later life really begin to form,” senior researcher Michael Wolf, director of the Center for Applied Health Research on Aging at Northwestern, told Gizmodo. “For that reason, it’s also the time when steps can be taken to prevent poorer health in later life.”
At the start of the study, participants were given a simple test used to evaluate health literacy, which asks people to read a nutritional label. They were also given a test of their self-management skills, which asked them to navigate through various health-related scenarios. Participants ranged in age from 35 to 64.
Overall, 13.2% of people had clearly low health literacy, while another 19.3% had a marginal level. People with low to marginal literacy were also more likely to fail the tasks they were given.
“A relatable example is medication dosing. We gave participants several medication bottles and asked them to show us how they would take them correctly over the course of a day. Many people struggled to get it right, whether by taking the wrong dose, missing important warnings, or finding it difficult to organize multiple medications with different instructions,” Vogeley explained. “A label might say, ‘Take twice daily,’ which sounds simple enough. But when you’re managing several medications, each written a little differently, organizing them correctly becomes much more challenging than people realize.”
Notably, people with low literacy were also more likely to have more chronic health conditions, to have more prescriptions, and to test lower on a cognitive screening test than others.
The team’s findings were published Wednesday in the Journal of General Internal Medicine.
The need for better health communication
The researchers aren’t looking to castigate people for their low health literacy. Instead, they argue we should be doing more to meet people where they are, such as with more intuitive drug labeling.
“Medications are an obvious example. Instructions for use are often vague, and can vary from one medication to another, from one doctor to another, or even one pharmacy to the next. Finding ways to have plain language and explicit steps on how and when to take them is common sense,” said Wolf.
The MidCog project will continue to keep an eye on these volunteers. And hopefully, the team’s work will eventually highlight how best to help everyone get the proper healthcare they need.
“What’s really exciting about MidCog is that we’re following the same people over time, so we’ll be able to move beyond a snapshot and better understand what actually happens down the road. One of the goals is to understand whether struggling with these health-management tasks in midlife is connected to worse health outcomes later in life,” said Vogeley. “Another goal is to identify ways to better engage middle-aged adults in their healthcare and support them in managing increasingly complex health demands.”
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