This is the 2nd post in our Health Equality blog series that will explore health literacy and health disparities in the U.S. Read Part I here.

Healthcare miscommunications is a $600 billion problem in the United States because our most expensive patients suffer from high hospital readmission rates and poor discharge adherence, directly correlating to low health literacy. The question is: How can patients and their caregivers follow healthcare instructions when they do not understand them?

My French Mother-in-law, Giselle, died because of a terrible misunderstanding after leaving the hospital. During discharge she was given the normal 15 pages of typed instructions. The only problem was that she spoke, but did not read, English very well. One of her instructions was to stop taking two current medications and start two new ones. Misunderstanding her instructions, she took ALL four medicine. Giselle spent 16 weeks in intensive care, the hospital ran up a $500,000 bill to taxpayers, and eventually she passed away.

Unfortunately, with 130 million people in the U.S. who, for various reasons, cannot read and understand medical instructions, Giselle’s situation is all too common. Medical mishaps are the third leading cause of death to the tune of 1,000 deaths a day. And medical mishaps also contribute to 20% readmission rates for hospitals.

Medical miscommunication also includes healthcare workers’ inability to understand the patient’s condition. One of the most famous case is a South Florida hospital paying a $71 million settlement because they thought the Spanish word “intoxicado” meant intoxicated instead of nauseated. The patient was treated for an intentional drug overdose instead of a brain hemorrhage and ended up as a quadriplegic. In a 2015 Study by Crico Research, 37% of all high severity injury malpractice cases involved a communication failure.

Often, low health literacy is associated with patients who are older, have limited education, lower income, chronic conditions, and those who are non-native English speakers. In the case of English as a second language, like Giselle, many people learn to speak another language but they do not read it well. In addition, low literacy is often generational and a caregiver may have as many problems understanding complex medical instructions as the patient. An individual’s embarrassment around their inability to understand healthcare instructions is not something we should take lightly, as 67.2% of low literacy patients had never told their spouses, and 53.4% had never told their children of their difficulties reading.

Therefore, improving health literacy is centers around understanding and making informed decisions to improve the quality of life for all of us.

Part 3 of the Health Equality blog series will focus on the Health Literacy and the Demographic Shift.