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Read every day. The prescription almost seems too simple, yet its potential impact for Canada's health-care system could be sizable.
What's the connection? It is well known that the determinants of health include things like income and the environment. Education, including early childhood learning, is also high on the list of those things that affect one's health and well-being. Obviously, reading is key in this regard. As well, when we need to use the health-care system or "illness system," our ability to participate in making good decisions rests, in large part, on communication - and reading is, again, key.
The importance of reading every day is one of the main findings from Health Literacy in Canada 2008: A Healthy Understanding, a recently published report on the state of health literacy from the Canadian Council on Learning.
The report found that daily reading is the strongest predictor of higher levels of health literacy. On average, as health literacy rises, individuals enjoy better health. And of course, as the health of the population improves, the burden on the health-care system is reduced.
What is the difference between standard literacy and health literacy? Simply defined, health literacy means an individual's ability to access, understand and use information related to their health or the health of their family. These skills go beyond the ability to read and comprehend prose - health literacy also encompasses numeracy and document literacy.
For example, in order to determine how much medication to give your child you need to understand the directions and calculate the appropriate dosage, by age or weight. Weakness in one area brings down your overall health literacy. Other examples include comprehending nutritional labels and understanding safety instructions.
CCL's report makes for a sobering read. Some 60 per cent of Canadians do not have the skills needed to adequately manage their health or health-care needs. And not surprisingly, Canadian adults with less than a high-school education perform well below those with higher levels of education. This gap increases with age, to the point where 80 per cent of seniors have low levels of health literacy.
Yet that is only the start.
The study reports that Canadians with the lowest health-literacy skills are two-and-a-half times more likely to report being in fair or poor health than those with the highest skills. They are also two-and-a-half times more likely to be receiving income support.
The report also examines the relationship between health-literacy scores and numerous illnesses, such as arthritis, high blood pressure and asthma. One finding in particular underscores why policy-makers and health practitioners need to pay attention to this issue: the prevalence of diabetes declines as health literacy increases.
By 2016, the number of Canadians with diabetes is expected to rise to 2.4 million, costing our health-care system more than $8 billion annually. While genetics is a key factor among others, diabetes is a disease that is highly influenced by individual behaviour. The ability of people to self-manage their diabetes treatment can influence their quality of life, longevity and the risk of complications. Improved health literacy can contribute to the prevention and management of diabetes as it plays a role in modifying behaviour and communicating core knowledge.
Of course, doing something about improving our overall level of literacy in Canada - and by extension health literacy - won't prevent or cure all of our ailments. But by raising awareness of our low levels of health literacy, CCL's report strikes a note of alarm for the health community, underlining the importance of improving accessibility to written materials provided to patients and exploring effective ways of using video and visual materials to communicate information. Such efforts are particularly important for seniors and for Canadians whose first language is neither English nor French.
The educational community can continue to do its part by ensuring a greater focus on health-literacy tasks within school systems and adult literacy programs.
Employers and unions must remain mindful of the need to ensure that on-the- job safety instructions are clearly written in plain language and understandable. And like the health community, they can enhance workplace health and safety by finding new and innovative ways to use visual media when training staff.
But at the end of the day, the strongest message is for individuals - if we want to improve our chances of staying in good health, the prescription for us and our children to read every day is certainly not a hard pill to swallow.
This article was first published in the Toronto Star on Mar. 6, 2008. Roy J. Romanow, former premier of Saskatchewan, is the founding chair of the newly formed Canadian Index of Wellbeing Institute Board.
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