Low health literacy and poor disease self-management are stronger predictors of a person’s health than age, income, employment status, education level, and race. In fact, the Journal of General Internal Medicine (JGIM) reports that poor health literacy results in a diminished ability to access the health care system, understand recommended treatments, and follow the instructions of providers. This not only decreases wellness but also costs the healthcare system somewhere between $106 billion to $238 billion annually. This represents a cost of $993/patient/year in additional healthcare costs.
Being low income is a significant predictor of low health literacy and poor self-management skills, with patients below the poverty level constituting 43% of the health illiterate and a majority of the poorly managed. With the implementation of the state and federal exchanges and the expansion of Medicaid, there is an ongoing influx of individuals into the healthcare ecosystem. Amidst this expansion, healthcare providers with limited resources are struggling to serve the increasing numbers of patients with low to modest incomes population. This necessitates innovative approaches to facilitate health care delivery and promote self-management.
While low health literacy, poor disease self-management, and limited healthcare resources are major challenges in the United States, these issues are not exclusive to this country. In fact, many of the most prevalent diseases faced by low-income patients, such as type 2 diabetes, hypertension, hypercholesterolemia, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and asthma (and associated behaviors such as nutrition, physical activity, stress management and smoking cessation), are increasingly common throughout the world.