Years ago, when I was in grade school, a relative mailed us a boxful of books one summer. They were the Dr. Seuss classics – “The Cat in the Hat,” “Horton Hears a Who,” “If I Ran the Circus,” “The 500 Hats of Bartholomew Cubbins.” There must have been more than a dozen of them, all bound in hardcover.
Every week Mom and Dad would select one new book from the box and read it aloud to me and my siblings. We loved those books and eagerly looked forward each week to the next one. Oh, sure, we had plenty of other books but these were different. They were special.
I remember it took most of the summer to work our way through the entire box. But that wasn’t the end. We continued to read the books over and over, until the pages were dog-eared and the binding started to fall apart.
This memory is one of the reasons why I pay attention whenever I hear about programs that instill a love of reading in children at an early age. Here in rural Minnesota, more than 2,000 kids receive books in the mail each month through Dolly Parton’s Imagination Library, an initiative by the United Way of West Central Minnesota with the Dollywood Foundation. Globally, more than half a million children under the age of 5 are registered in the program.
So why are you reading about children’s books on a blog that’s supposed to be about health? Because the two are connected far more closely than their surface appearances might suggest.
Health literacy, defined as the ability to obtain, process and understand health information and make appropriate decisions, is a major – and often underappreciated – factor in how healthy we are (or aren’t). Perhaps even more than income or education level, it’s one of the critical pieces in health status and health outcomes.
It’s not hard to find statistics about health literacy or overall literacy in the U.S.; a simple Google search will do. And much of the information is eye-opening. For instance, two-thirds of American adults over age 60 are thought to be inadequately literate. A study published in the mid-1990s in the Journal of the American Medical Association found that 81 percent of patients 60 and older who were interviewed at a public hospital were unable to read or understand basic information such as prescription labels.
Although the effects of low literacy aren’t always easy to measure in a health setting, the implications are obvious. It’s harder for these individuals to follow directions for taking a medication safely and correctly. They can have difficulty understanding test results or a new diagnosis. They might struggle to manage a chronic condition such as diabetes or asthma. They might make health decisions that don’t adequately weigh the risks and benefits.
It creates a costly and sometimes life-threatening undertow within the U.S. health care system.
Multiple studies have documented a link between low health literacy and higher use of emergency-room care, greater likelihood of hospitalization, higher risk of taking medications incorrectly, lower rates of flu immunization and, among women, underuse of screening mammograms.
Why is literacy difficult for so many people to accomplish? It’s a question that doesn’t seem to have a single, handy answer. Many factors are thought to contribute – poverty, learning disabilities, chaotic family situations, ineffective strategies to help students who aren’t performing at grade level, mental health issues, cognitive declines in older adults, and even rising expectations for what constitutes literacy.
What’s clear is that low literacy is a societal issue that can’t be solved by the health care system alone, and that it often starts in childhood with children who are unprepared for kindergarten and who often fall farther and farther behind as they progress through school.
This doesn’t mean health care organizations should sit back and let the school system take care of it, however. I’m always impressed whenever I hear about providers who have been purposeful in promoting literacy and learning as part of their patient care.
Here’s how they’re doing it in my own backyard, with the Reach Out and Read program at Affiliated Community Medical Centers. According to a recent story posted on its blog, ACMC gave out more than 10,000 new books last year during well-child visits.
Dr. Amber Vick, a family physician, had this to say:
“It’s always a special time for me when I have the opportunity to give a child a book. When I give out the books, I make sure to tell the child that I am giving them a book to take home and read with mom and dad. We want kids to know that reading is important, and we also want them to know it’s an important thing to do with their parents.
Providers also use the books to assess how well children are meeting developmental milestones – if they’re able to hold the book properly, for instance, and correctly identify colors or pictures. In a measure of its belief in the critical importance of early childhood learning, ACMC commits $24,000 a year to sustaining the Reach Out and Read program.
This may be one small effort but when it comes to preparing young children for success in school, every little bit seems to help. It’s to be hoped that when these youngsters become old enough to start making their own health decisions, they’ll be more capable, more informed and better off for being literate. When you give a child a book, it really can lead, however indirectly, to better health.