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Lower Literacy Puts Poor Health In Aging

adjunct professor of medicine at UCSF. ‘Elders already have the highest medication and disease burden. Adding limited literacy to the list of problems makes these elders particularly vulnerable to poor outcomes, as we found in our study.’

The study analyzed data from in-person interviews of participants in the Health, Aging, and Body Composition Study conducted by the National Institute on Aging. Study subjects lived independently in the community in Memphis, Tenn., or Pittsburgh, Penn. The study excluded participants with dementia or poor physical functioning. ‘Elders with limited literacy have a hard time reading their pill bottles, managing their diseases, filling out needed forms for their care, and being able to navigate through the health care system,’ notes Sudore. ‘Unfortunately, in this study, we found that the very group of elders who would benefit from having more access to health care actually had worse access. Since the elders in our study were fairly well-functioning, problems accessing care and managing disease are likely to be even worse for frailer elders.’

The design of the study precluded an exploration of the reasons for the links between literacy, health, and health access, says Sudore, but she offers some possible explanations: ‘Patients with limited literacy may not understand instructions given to them by their clinicians, or grasp the importance of follow-up care. In addition, there may be elements of fear or intimidation or lack of trust in the health care establishment.’ Plus, she says, limited literacy may prevent elders from being able to properly fill out forms needed to obtain medical resources such as insurance and medications.

Sudore points out that among the study participants, literacy did not necessarily correlate with level of education, ‘which suggests that simply asking if someone graduated from high school will not tell you whether the person can understand his or her physician or read a pre
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