Tuesday, April 23, 2013

Health Literacy and Preventive Care

In my last blog, I mentioned that health literacy includes the skills and knowledge necessary to navigate the health care system. Today, let's take a look at the part of the health care system that helps to keep us healthy-preventative care.

Prevention is the key is to excellent medical care in most of the world. The US traditionally has thought of prevention as unnecessary. This attitude is reflected in the fact that our original health insurances were hospitalization only plans. Nowadays, people often have health insurance out of a fear of big hospital bills, but they don't use the preventative care that insurers will cover. This is a costly mistake.

Preventative services include seeing your primary care doctor once a year when you are healthy. Parents are pretty good about doing this for their kids, but often skip it for themselves. When you see your doctor, he (no disrespect meant, I'm going to refer to your provider as he)  should be asking about your lifestyle:not just do you smoke or use drugs, but your job, your driving habits, what you usually eat and how much you work out. He will run you through a series of quick tests to see how your body is functioning- blood pressure, urine tests, blood tests, vision and hearing will all be screened. He is looking for the earliest warning signs that your body is not handling life well. If all is fine, he should be suggesting small changes you can make to continue to live as healthy as possible. If there are signs that small things are going wrong, he is going to make suggestions on how to improve your health and explain what medical interventions may need to happen if you cannot improve your health on your own.

There are other screening tools that the doctor may order based on your age, lifestyle choices, sex, and family history. Mammograms, EEGs (heart tests), prostrate exams, neurological exams, HIV testing may all be suggested. It's important that you understand the health risks involved in both participating in these exams and in refusing these tests. There are very few good reasons to refuse a screening exam. These are critical ways the doctor has to help you stay healthy. Fear of the outcome should never stop you from taking the test. The earlier the doctor finds something wrong, the easier it is to treat. In my family, my cousin died of skin cancer because he refused to allow the spot on his face to be examined, even when it grew rapidly. Instead of listening to his doctor that he needed to have it checked by a dermatologist when it was small, he stopped going to the doctor. When he finally sought medical attention, it was too late to save his life; the cancer had spread through his body.

Speaking of a dermatologist (skin doctor), prevention may mean seeing a specialist. There are 13,000 known conditions that can affect the human body and no doctor is proficient in all of them. Most are really great at treating about 2000 of them. The other 11,000 diseases will require a trip to a different doctor.  It's not a sign that you are seriously ill, it's a sign that your primary doctor doesn't treat that set of symptoms enough. Frequently people see the specialist and then discover the problem is  something easily treatable. You want the doctor with the most experience looking at your symptoms and your body.

Preventative care also includes vaccinations. Vaccinations are most often created for viruses that affect our bodies. Viruses do not respond to antibiotics of any kind and are, in general, untreatable. Like the common cold, when you get one of these viruses, you are simply sick until you get better. Many of the viruses for which there are vaccinations create illnesses that kill or seriously maim the infected person. One of the huge fallacies in the world right now is that these viruses are no longer a threat to us. This leads parents to often skip vaccinating their children. The viruses are still out there though. The only virus for which we have a vaccination that does not occur anywhere in the world is small pox; and we no longer vaccinate for that illness. This was a unique virus that only infected humans. Most viruses pass between humans and animals,  and so they become impossible to fully eradicate. As more people refuse vaccinations, we will see a spike in diseases that the average American thought were gone. This could leave us vulnerable to an US outbreak of disease that rivals the bird flus coming out of the China and other eastern countries.

In summary, it's important that we all visit the doctor and use the preventative services provided. There may be some legitimate reasons why a particular screening or vaccine is not appropriate for you, but these reasons should not be based on a broad fear of a reaction or the results. If you have concerns about a particular preventative service, talk it over with your doctor. If you are concerned with the cost, mention that to your doctor too. There are lots of free and low cost programs out there to help you with the financial aspects of staying healthy. The programs are there to help keep you healthy.

So then let me ask you, when was the last time you saw your doctor for a well visit? Did your doctor suggest a preventative measure? Did you do it or did you put it off? Why? What are you doing instead of the doctor's suggestion to keep yourself healthy? Is it working? And finally, what can you do today to make sure you are taking good care of yourself? How about scheduling that appointment you have been putting off? It's all for your healthy future!

Thursday, April 4, 2013

Health What?

Welcome to my new blog! So for those of you who know me, you have a vague idea of what health literacy is. For those of you who are still struggling to figure out what Health Literacy, this blog is for you! Upcoming blogs will focus on how to improve your health literacy and hopefully get you thinking about how to improve your health as well.

In the meantime, Health What???

Health Literacy is a set of skills and knowledge that people need to navigate the health care system, make healthy choices, and respond appropriately in a public health crisis. If you have ever tried to decide between two different medical treatments, forgotten to take your medications, wished you understood what your doctor was saying, or tried to live healthier but got confused by the research out there, your health literacy skills need improvement. Don't be insulted though, our federal government estimates only 12% of English speaking Americans are fully health literate. Factor in the 20% of Americans who do not speak English at home, and the fact that skills related to public health emergencies were not included in this estimate, we are really taking about only 3-4% of Americans being fully health literate. This is a real crisis in our health care system!

So if our government knows how bad it is, what's being done to improve health literacy skills in Americans? Sadly,very little. Our medical system has known that people aren't as health literate as they should be since the 1980s when AIDS and Breast Cancer patients both began demanding more information about treatments and their care. The medical system has slowly responded to the lack of health literacy skills, by providing information in easier to read formats, speaking slowly, encouraging patients to ask questions, and using techniques like the teach back method to ensure the patient understands what is going on. None of these things however, teach the patients the health literacy skills they need to be successful. It's like saying Johnny Can't Read, so dumb down the curriculum instead of teaching Johnny to read!

As a public health educator, with a history of special education and designing training programs, it didn't take me long to identify the need to teach people these skills. So, after months of research on what the skills are that the medical field feels is lacking, I designed a comprehensive program called "Health Literacy and You" to teach patients how to be fully health literate, as well as to teach providers how to be better communicators. As word has spread through the Capital District, I am finding more and more people who are anxious to learn these skills and as a result live a healthier life.

So now that you have an idea what Health Literacy means, where are you struggling with these skills? What topics do you wish you understood better, in order to live a healthier life? Share your thoughts and I can generate blogs to answer those questions, because if you have them so do other people. In the meantime, choose to do something healthy today!