Research performed at the University of Toronto revealed that part of the problem is that health care professionals may think that overall literacy indicates health literacy. The researchers found that this is not the case. They also found that health care professionals may not be aware of barriers such as culture, language, and age. Researchers at Emory University in Atlanta examined nearly 3300 Medicare recipients and found that more than half of the Spanish-speaking respondents had, at best, marginal comprehension levels, compared with a third of English speakers. The study also showed that low literacy levels increased with age, from roughly one-sixth of respondents aged 65–69 to more than one-half of respondents aged 85 and older (J. Am. Med. Assoc. 1999, 281, 545–557).

Experts in the field think that inadequate health literacy puts the burden on health care professionals to develop methods of communicating medical information more effectively. They say that patients, regardless of their education level, cannot be expected to be responsible for understanding medical diagnoses.

One technique for improving medical comprehension is for doctors to use a “teach back” approach, like that used to instruct students in school. Several studies in progress are examining the benefits of using visual elements, rather than medical texts, to complement the doctor’s explanation. Some of these methods include pictorial diagrams and multimedia software. The studies seek to determine whether patients who are given access to diagrams, videos, and multimedia software will have better clinical knowledge than those without such access.