According to the National Action Plan to Improve Health Literacy, nearly 9 out of 10 adults have difficulty using routine health information. Concerned about Georgia and literacy rates in general, Gov. Nathan Deal has joined other states in declaring October as Health Literacy Month.

Don Rubin is focused on community work—“meaningful things,” he says. The 66-year-old left his full-time teaching and research work at the University of Georgia a few years ago and began volunteer jobs he thought would allow him to make a difference to his neighbors.

“I saw my university departure as an opportunity to jettison those parts of my work life that were [lost] time (such as faculty meetings, updating my annual report) and beginning to focus on ways I could use my time and talents to do things that were consequential,” he said. “I had published lots of research articles and given lots of lectures, but I really had never spent a lot of time in community-based organizations.”

Don Rubin

Rubin began by volunteering as a family literacy tutor for refugees and helping with some health communication projects for the Meals on Wheels organization. He then had an opportunity to help train Affordable Care Act (ACA or Obamacare) navigators. The experience was eye-opening for Rubin. It taught him how hard it can be to explain how health insurance works.

“This is especially true when end users have never before had a regular doctor,” he said. “The more I interacted with members of diverse communities, the more I realized that most Georgians want more wellness in their lives.”

However, Rubin says, many lack the tools for figuring out exactly how to achieve that. “Much of the information made available to them is just an impenetrable wall of words and numbers,” he said. “That’s where health literacy comes into play.”

Soon, Rubin was up to his earlobes in the Georgia Alliance for Health Literacy (GAHL), a volunteer coalition representing educators, researchers, government officials, healthcare providers, healthcare payers and consumers. Rubin has served as executive committee chair for the past two years of the 5-year-old Georgia nonprofit’s existence.

Health literacy is a critical issue, especially when it’s time to choose a treatment or surgical procedure. People are often required to make the best choices under the worst of circumstances, and they may have minimal experience and almost no understanding about the entire system and how it functions.

Being able to read and yet not being able to understand the information is of little value, especially when it pertains to health and making informed medical decisions. Most older adults can read very well, but, unfortunately, unless they’ve been to medical school, the language of health—or as Rubin calls it, the ‘gobbledy-gook’—can be baffling.

GAHL members raise health literacy awareness in many ways, including workshops for patients and consumers that cover making the most of medical appointments and learning how to search online for reliable and unbiased health information. For health providers, GAHL provides materials to help ensure patient comprehension via teach-back techniques—where a patient is asked to repeat the information and ‘teach it back’ to the healthcare provider—as well as customizable ‘Health Literacy 101’ workshops.

When comprehending medical information is foreign to patients, they are at risk of missing meds, forgetting about vaccinations and even getting medications confused, which can lead to expensive emergency room visits.

The Associate Director of the Adult Literacy Research Center at Georgia State University, Dr. Iris Feinberg, says that every year, the state collects surveillance data on different health and well-being measures.

Dr. Iris Feinberg

“In 2015, we added health literacy questions to assess the levels of health literacy in the state,” she said. The results suggest that half of adults ages 55 to 64 had less than proficient health literacy skills, and that the percentage grows to almost 60 percent for those aged 65 and older.

“Less-than-proficient health literacy means it’s harder to understand, access and use both medical terms and the medical system,” explained Feinberg.

It also means that adults of any age with less proficient health literacy are twice as likely to report fair to poor general health than those with proficient health literacy skills.

Licensed Master Level Social Worker (LMSW) and case manager Brandi Hackett works solely with a focus on geriatrics (including adults with disabilities). “The understanding of the complexities of health literacy with our clients and their support networks is vital in the work we do,” said Hackett. She took the helm as GAHL’s leader in August.

“As medical social workers, we identify and remedy the potential gaps in understanding regarding their medical conditions, or how to proactively to avoid medical crises,” she said. “Medical social workers are the built-in patient advocates on the health care team. A primary focus of my role is to assist my patients and clients to obtain, process, understand and use health information before making health decisions.”

The risk of low health literacy can be increased by the stress of the medical situation, Hackett says. For example, infections or illness may lead to a temporary inability to process or retain the information. Also, the ability of the brain to process unfamiliar changes is affected when there’s a surfacing medical need, such as cancer or an addiction, limiting comprehension.

“I often see those I serve assuming they need less guidance. But, this is not just a poor and poorly educated issue,” she said. Many patients and their caretakers are not educationally poor. In fact, many are very well educated, Hackett says, and she reminds her clients that money does not equal knowledge.

For Rubin, working in the community made clear the need for health literacy and for what GAHL and medical social workers do. “The more I interacted with members of diverse communities, the more I realized that most Georgians want more wellness in their lives, but many people lack the tools for figuring out exactly how to achieve that,” he said.


Where to Get Help with Medical Information

There’s a lot of health information available at local libraries, and through medical social workers and medical librarians at community hospitals. Of course, there’s always the Internet, but that can become a minefield of misinformation. Here are some reliable websites.

A very helpful article, “The Smart Way to Search the Internet for Health Information” was posted on the Forbes website on March 31, 2017. It’s worth finding and reading before you start researching health information online.


Judi Kanne

Judi Kanne is a public health communications consultant and contributing writer to Atlanta Senior Life.