The Partnership for Clear Health Communication is a coalition of national organizations that are working together to promote awareness and solutions around the issue of low health literacy and its effect on health outcomes.

A Hidden Health Crisis a Serious Impact
As an emerging public health issue, low health literacy is often misunderstood as a condition that affects a specific portion of the population. In reality, its scope is broad and its impact severe.

Although low health literacy can affect everyone regardless of background or educational level, studies on the issue show that limited literacy skills are a stronger predictor of an individual's health status than age, income, employment status, education level, and racial or ethnic group.

Although ethnic minority groups are disproportionately affected by low literacy, the majority of those with low literacy skills in the United States are white, native-born Americans.

What is Health Literacy?
Health literacy is the ability to read, understand and effectively use basic medical instructions and information. Low health literacy can affect anyone of any age, ethnicity, background, or education level.

People with low health literacy:

• Are often less likely to comply with prescribed treatment and self-care regimens.
• Fail to seek preventive care and are at higher (more than double) risk for hospitalization.
• Remain in the hospital nearly two days longer than adults with higher health literacy.
• Often require additional care that results in annual health care costs that are four times higher than for those with higher literacy skills.

Why is Health Literacy Important to Me?
Chances are high that some of your patients are among the 90 million people in the United States whose health may be at risk because of difficulty in understanding and acting on health information. In fact, you may not even know that these patients are in your practice because:
They are often embarrassed or ashamed to admit they have difficulty understanding health information and instructions. They are using well-practiced coping mechanisms that effectively mask their problem.

What is Ask Me 3?
Ask me 3 promote three simple but essential questions that patients should ask their providers in every health care interaction. Providers should always encourage their patients to understand the answers to:

1. What is my main problem?
2. What do I need to do?
3. Why is it important for me to do this?

What Can Providers do?
Health literacy is now known to be vital to good patient care and positive health outcomes.

Answer 3
Along with encouraging your patients to use the Ask Me 3 approaches, simple techniques can increase your patients' comfort level with asking questions, as well as compliance with your instructions after they leave appointments.

• Create a safe environment where patients feel comfortable talking openly with you
• Use plain language instead of technical language or medical jargon
• Sit down (instead of standing) to achieve eye level with your patient
• Use visual models to illustrate a procedure or condition
• Ask patients to "teach back" the care instructions you give to them

For more information on Cultural Competency, visit the following resources:

• National Center for Cultural Competence (NCCC):
  http://www11.georgetown.edu/research/gucchd/nccc/
• The Provider's Guide to Quality & Culture:
  http://erc.msh.org/
• The Cross Cultural Health Care Program
  http://www.xculture.org/about.php
• Henry J. Kaiser Family Foundation and Robert Wood Johnson Foundation Initiative
  http://www.kff.org/whythedifference/index.htm
• The Office of Minority Health
  http://www.omhrc.gov/