Low health literacy level alarming, making Filipinos ‘more sick’ – doctor

The low level of health literacy among Filipinos, notably among the underprivileged, is one of the key drivers causing the ranks of unhealthy and sick Filipinos to swell at an alarming rate, medical and health industry leaders have warned.

At a recent health forum, Philippine College of Physicians president Dr. Anthony Leachon described the stark situation in the country this way: “When patients come to us to seek medical advice, they are very sick already. This should not be the case. This is failure of health literacy.”

The US Centers for Disease Control and Prevention (CDC) defines health literacy as “the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.”

“In the Philippines, we have failed in health literacy. Why? We have a lot of medical and health knowledge, but many Filipinos fail to comply with what is needed and must be done about their health,” Leachon said.

When both a patient and his doctor understand each other, that is a “form” of health literacy, he said. “But this is not always the case.”

Danilo Chiong, health business unit director of a pharmacy chain, illustrated the low health literacy among Filipinos buying medicines in his company's outlets.

“Thirty out of 100 of our customers who buy medicines in our outlets are actually taking hypertensive medicines. However, of the 30 patients, 12 of which will stop taking medication on the second month, and only three will continue their medication in a year’s time,” Chiong said.

“This is an alarming indication of the low level of health literacy in the Philippines,” he added.

Customers buying medications always ask questions which must be properly and appropriately answered by pharmacists. “Otherwise, the unanswered questions may lead to a bigger concern, such as self-medication or total disregard of a potential health risk,” Chiong said.

Poor and under-informed

Leachon said grinding poverty and the accompanying low level of education among poor Filipinos aggravate the low health literacy among them, leading further to the dismal health situation in the Philippines.

Citing examples of worrisome health indicators, Leachon said that the epidemic of non-communicable diseases (NCDs) or “lifestyle diseases,” initially diagnosed among rich Filipinos, is now startlingly and rapidly killing even their poor counterparts.

“The top [NCD] killers are related to lifestyle: smoking, unhealthy diet, and lack of exercise. The poorer you are, the more you are affected by lifestyle diseases, with three out of five Filipinos dying daily because of lifestyle diseases,” Leachon said.

Heart attacks, cancers, chronic obstructive pulmonary disorder, and diabetes are among the top NDC killers, he added.

The shortage of medical doctors and other health professionals in rural areas, coupled with the lack of health infrastructure in the countryside, intensify the impact of this low health literacy.

“The problem of migration of doctors to urban areas, leading to shortage of doctors in certain areas of the country, produces inequity,” Leachon said.

Cure more expensive than prevention

Leachon also decried the “curative” rather than “preventive” approach in managing people's health, and urged the introduction of health literacy awareness among Filipinos at the earliest age appropriate.

“We should educate Filipinos about health literacy at a very, very early age. Even as early as their elementary school education, if possible. People eat unhealthy food because they are cheap. But in the long run, these eating habits become more expensive. These cheap, unhealthy foods cause NCDs,” Leachon said.

“If you are poor, you have no access to disease prevention and treatment. If you are poor, you have higher probability of dying from NCDs. If you are poor, you have higher mortality rate but you also have limited reserves. Health expenses drive poor Filipinos to deeper poverty,” Leachon said.

Needy Filipinos are forced to seek Philippine Charity Sweepstakes Office financial assistance or troop to the offices of their congressmen to solicit monetary help to pay for hospital bills or to buy medicines, he added.

US numbers

The Philippines is not the only country having to deal with the problems caused by low health literacy.

In the US, for example, the National Assessment of Adult Literacy released by the US Department of Education in 2006 revealed that only 12 percent of American consumers have proficient health literacy skills, suggesting that nearly nine out of 10 adults may lack many of the skills necessary to sufficiently manage their health.

The CDC said that low health literacy can affect a person’s ability to locate health care providers and services, fill out health forms, share personal health information with providers, manage chronic diseases, and engage in self-care.

About one-third of US adults have trouble reading and acting on health-related information and that even those with higher health literacy skills want health information that is understandable, meaningful to them, and easy to use, the CDC said.

“Limited health literacy occurs when people cannot find and use the health information and services they need. Nearly 9 out of 10 adults have difficulty using the everyday health information that is routinely available in healthcare facilities, retail outlets, media, and communities,” the CDC said.

“Without clear information and an understanding of the information's importance, people are more likely to skip necessary medical tests, end up in the emergency room more often, and have a harder time managing chronic diseases like diabetes or high blood pressure,” the CDC added.

Leachon said access to easy-to-understand health information and “understanding” them are crucial in the daily decision-making processes of every Filipino concerned with his or her health.

Among the factors that affect the low health literacy of Filipinos are their reading and numeracy skills, language abilities, and the “cultural appropriateness, format, and style” of health messages or information. — BM, GMA News