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Low literacy increases risk of death and misunderstanding of medical consent forms

Literacy at less than a ninth-grade level almost doubles the five-year risk of mortality among elderly people, regardless of education, socioeconomic status, or health, according to a study led by a researcher at the San Francisco VA Medical Center.

"From a public health standpoint, this has important implications," says lead author Rebecca Sudore, MD, a staff physician at SFVAMC and an assistant professor of medicine at the University of California, San Francisco. "Poor literacy appears to have long-lasting effects on patients' health. This is yet just one more reason why improving the educational system in the US is so important."

The study appears in the August 2006 issue of the Journal of General Internal Medicine, a special issue devoted to the topic of health literacy.

In another study led by Sudore that appears in the same issue, findings showed that only 28 percent of adults understood a highly simplified medical consent form the first time they encountered it, even after extensive modification of the consent process in order to improve understanding. The form, written at a sixth-grade reading level, was read aloud to subjects in English or Spanish as they read it for themselves.

"We cannot make the assumption that anyone, even highly literate native English-speakers, will understand medical consent information," asserts Sudore.

The literacy and mortality study analyzed data on 2,512 participants in the Health, Aging, and Body Composition Study that was conducted by the National Institute on Aging from 1999 to 2004. Study subjects, aged 70 to 79, lived independently in the community in Memphis, Tennessee or Pittsburgh, Pennsylvania. The study excluded participants with dementia or poor physical functioning.

Among participants with limited literacy defined as a reading level of less than ninth grade the death rate was 20 percent. Among all others, the death rate was 11 percent. After taking into acco
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Contact: Steve Tokar
steve.tokar@ncire.org
415-221-4810
University of California - San Francisco
3-Aug-2006


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