Health Literacy Among Medicare Enrollees in a Managed Care Organization

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Abstract
In 1993, the National Adult Literacy Survey (NALS) reported that 44% of adults aged 65 years or older scored in the lowest reading level (level 1), meaning they could not perform the basic reading tasks necessary to fully function in society.1,2 However, because the test used in the NALS did not include health-related items, it is unclear how many elderly persons cannot read adequately to function in health care settings. One study measuring patients' functional health literacy at a public hospital found that 81% of English-speaking patients aged 60 years or older had inadequate health literacy.3 These patients could not correctly read basic items commonly encountered in the health care setting, such as prescription bottles and appointment slips.3 Another study of low-income community-dwelling adults aged 60 to 94 years found mean reading skills at a fifth-grade level.4

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