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Elderly/Long-Term Care

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Elderly Medicare patients with low health literacy receive little tangible support for their health care needs

Low health literacy, prevalent among the elderly, limits their ability to comprehend health information and to follow medical instructions which, in turn, can harm their health. Yet, 60 percent of elderly Medicare managed care plan members who had trouble understanding medical information received little or no social support from others, according to a new study.

This low literacy group was much more likely than their more health literate counterparts (40 vs. 12 percent) to receive read help reading information on drug labels or filling out medical forms at least some of the time; however, they were less likely to receive tangible support, which was linked to better physical and mental health in both groups. Tangible support included having someone drive them to the doctor's office or help them with meals or chores if they were sick.

Two additional types of social support—medical information and healthy reminder support (for example, reminders to take medication or to follow dietary restrictions)—were significantly correlated with worse physical and mental health in both groups. It could be that older adults in poorer health are in need of, and therefore receive, more of these types of support, note the researchers.

Yet, healthy reminders were correlated with more frequent doctor visits and lower risk of hospitalization in the high health literacy group. The study was supported by the Agency for Healthcare Research and Quality (HS13004).

See "Health literacy and social support among elderly Medicare enrollees in a managed care plan," by Shoou-Yih D. Lee, Julie A. Gazmararian, Ph.D., and Ahsan M. Arozullah, M.D., M.P.H., in the August 2006 Journal of Applied Gerontology 25(4), pp. 324-337.

Editor's Note: In a related study, also supported by the Agency for Healthcare Research and Quality (HS13233), researchers developed and validated a health literacy test, the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA). Validation of SAHLSA involved testing and comparing the tool with other health literacy instruments in a sample of 201 Spanish-speaking and 202 English-speaking subjects recruited from one ambulatory care center.

The SAHLSA-50 score was significantly and positively associated with the physical health status of Spanish-speaking participants, holding constant age and years of education. The instrument displayed good internal reliability and test-retest reliability. The researchers conclude that the SAHLSA-50 could be used in the clinical or community setting to screen for low health literacy among Spanish speakers.

For more information, see "Development of an easy-to-use Spanish health literacy test," by Shoou-Yih D. Lee, Ph.D., Deborah E. Bender, Ph.D., M.P.H., Rafael E. Ruiz, Sc.M., and Young Ik Cho, Ph.D., in the August 2006 Health Services Research 41(4), pp. 1392-1412.

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