Literacy Promotion in Healthcare Settings The Medicare Population	Return to Facts Overview References

In 1992, 26% of adults in NALS Level 1 reported physical, mental, or other health conditions that prevented them from participating fully in work, school, and other activities.
(Kirsch, p43)

The relationship between adults' health conditions and their literacy skills varies depending on the condition. Adults with conditions such as hearing difficulty, a speech disability, a learning disability, or mental retardation have Level 1 skills. Adults with other conditions have level 2 skills.
(Kirsch, p44)

In a 1993-94 study conducted at two public hospitals, 23.6% of patients with inadequate functional health literacy did not know how to take medication four times a day, compared to 9.4% with marginal functional health literacy and 4.5% with adequate functional health literacy. 81.1% of patients with inadequate functional health literacy did not understand the rights and responsibilities section of a Medicaid application, compared to 31.0% with marginal functional health literacy and 7.3% with adequate functional health literacy.
(Williams, p1680)

In a 1995-6 study of the relationship of literacy to asthma knowledge:

• 31% of asthma patients with a reading level of third grade knew that they need to see their physician even when they are not having an asthma attack, compared to:

    93% with a high school graduate reading level
    80% with a 7-8th grade reading level
    63% with a 4-6th grade reading level


• 45% of asthma patients with a reading level of third grade knew that they should stay away from things that they are allergic to even when they take their asthma medication every day, compared to:

    89% with a high school graduate reading level
    77% with a 7-8th grade reading level
    59% with a 4-6th grade reading level      
(Williams, p1011)

Literacy Promotion in Healthcare Settings

A literacy promotion study in a primary care setting with low-income Hispanic parents of healthy 5-11 month old infants found that:

• 52% of intervention parents reported having at least five children's books at home compared with
• 19% of the parents in the control group.      
  (Golova, p995)

In the same study, it was found that the likelihood of parents reading to their child three or more days a week was:

• 10 times greater in the intervention families than the control families, and that
• parents in the intervention group were six times more likely than were control parents to report that one of their three most favorite activities with their child was reading books.      
  (Golova, p996)

A literacy promotion study, conducted in a primary care setting with a multicultural group of low-income families, found that:

• intervention parents read to their child 4.3 days a week compared to 2.8 days by the control group
• intervention parents read to their child at bedtime 3.4 nights a week compared to 2.1 nights by the control group
• 61% of the children in the intervention families had more than ten books compared to 45% in the control group
• 78% of intervention parents read to their child three or more times a week compared to 46% of the control group      
  (High, p931)

The Medicare Population

20% of Medicare beneficiaries with 0-8 years of schooling reported that they knew all or most of the Medicare information they needed. This compares to:

• 29% of beneficiaries with 9-11 years
• 35% of beneficiaries with 12 years
• 40% of beneficiaries with 13-15 years
• 47% of beneficiaries with 16 or more years    
  (Health Care Financing Administration, p33)

In 1998:

• 33.70% had 12 years of schooling
• 20.19% of all Medicare beneficiaries had 0-8 years of schooling
• 15.94% had 9-11 years of schooling
• 15.89% had 13-15 years of schooling
• 14.28% had 16 or more years of schooling.    
  (Health Care Financing Administration, p41)

Benefit payments (in millions) of Medicare beneficiaries with 0-8 years of schooling was $44,010 compared to:

• $34,238 for those with 9-11 years
• $62,610 for those with 12 years
• $29,063 for those with 13-15 years
• $22,919 for those with over 16 years    
  (Health Care Financing Administration, p95)

In a 1997 study of community-dwelling Medicare enrollees in a national managed care organization:

• 54.3% of enrollees with inadequate literacy levels did not know how to take medication on an empty stomach, compared to:
      33.7% with marginal health literacy
      15.6% with adequate health literacy



• 67.7% of enrollees with inadequate literacy levels did no know how to interpret low blood sugar values, compared to:
      45.3% with marginal health literacy
      23.5% with adequate health literacy



• 100% of enrollees with inadequate literacy levels did not understand the rights and responsibilities section of a Medicaid application, compared to:
      93.7% with marginal health literacy
      17.3% with adequate health literacy.    
  (Gazmararian, p548)