Addressing Low Health Literacy in Surgical Populations

Health literacy is defined as the ability to obtain, engage, understand, and act upon health information to make decisions about health care. Health literacy is a key determinant of health outcomes and disparities including those in surgery. Over one-third of surgical patients suffer from low health literacy, with disproportionately higher rates among older, rural, and black patients. Low health literacy has been associated with poor adherence to preoperative and discharge instructions, longer lengths-of-stay, higher readmission rates, and higher health care costs. However, health literacy is modifiable, and therefore it is uniquely positioned for meaningful interventions at the patient, provider, and system level. These interventions include using more visual aids with patients and families (patient level), communicating in more understandable ways (provider level), and improving the organizational health literacy of hospitals (system level). Through high-quality research and multilevel interventions, significant opportunities exist to address low health literacy and improve outcomes, eliminate disparities, and reduce costs for this disparity population.