Low Health Literacy (LHL): A Devious Enemy of Patient Treatment Adherence [Full Length Review]

A. LHL is associated with people who cherish superstitions and stigma within their preset narrow mind, which prevents them from gathering relevant health information from their surroundings. B. LHL has a significant impact on patients' treatment guideline compliance, or, more directly, medication adherence, which leads to poorer health outcomes, higher healthcare costs, increased hospitalizations, and even higher mortality rates. C. Only 12% of Americans have adequate health literacy, and improving health literacy could prevent nearly 1 million hospital visits and save more than $25 billion per year, according to the US Centers for Disease Control and Prevention (CDC). D. The global economic cost of illiteracy is estimated to be $1.19 trillion, but LHL alone costs the US economy $238 billion per year. E. Both are found in both developed and developing countries around the world, and socioeconomic factors are not the only cause of LHL. F. Surprisingly, nearly 40% of US and UK adults have LHL, compared to around 50% of Europeans, 60% of adults in Canada, Australia, and the UAE, and nearly 70% of Chinese. G. In China, health literacy increased from 6.48% of the population in 2008 to 23.15% in 2020. However, only 1 in 5 military health providers of the Chinese People's liberation Army had adequate health literacy, found in a recent survey published in BMC Public Health. H. Evidence suggests that LHL has significant economic consequences at the individual, employer, and healthcare system levels. I. The authors of the Hamburg Diabetes Prevention Survey, a population-based cross-sectional study in Germany, concluded that LHL is a significant risk factor for the metabolic syndrome's three conditions: obesity, diabetes, and hypertension. J. Age, place of residence, education, and family status all have an impact on health literacy. K. More than half of Dutch health providers use health literacy-specific materials only infrequently. L. Mistrust and LHL perceptions were linked to high levels of vaccine hesitancy, providing evidential support for portraying these factors as perceived barriers to COVID-19 vaccine uptake. M. LHL is not uncommon among patients with a high level of education or with well-off patients. Moreover, patients with LHL, but with high education, had a higher probability of emergency department (ED) re-visits. Empirical research based on a conceptual model estimated that LHL costs between 7 and 17% of total healthcare expenditures. N. According to patient-centered interventions, improving health literacy can reduce the risk of polypharmacy, medication non-adherence, and healthcare costs. O. According to the 1996-2017 Medical Expenditure Panel Survey, LHL was more prevalent in glaucoma patients, and patients with LHL were prescribed more medications and had higher medication costs. P. Nearly 35% of diabetic patients worldwide have limited health-related education. Q. LHL is linked to gestational diabetes, maternal stress and depression, low birth weight, stillbirth, and congenital malformations during pregnancy and birth, all of which have negative consequences for the woman and her child. R. Health literacy among the population is expected to rise over time in this era of modernization. According to a national survey conducted in the Czech Republic in 2015-16, nearly 60% of Czechs have LHL. Surprisingly, a 2018 survey revealed that health literacy in the Czech Republic was still declining. S. The prevalence of LHL in the ED varies greatly, with estimates as high as 88% depending on the patient mix and screening instruments used. T. In both low and high-income countries, low parental health literacy was linked to poorer child health outcomes. U. Patients who are older, have less education, a lower income, and have chronic conditions are more vulnerable. V. LHL was discovered in more than 70% of formal paid caregivers of non-self-supporting older adults in Tuscany, Italy, and in more than 50% of caregivers of heart failure patients in the United States. W. People with LHL may have 1.5-3 times the number of serious health outcomes, such as higher mortality, hospitalization rates, and disease management ability, as those with adequate health literacy. X. In cardiac patients, it has been linked to increased mortality, hospital readmission, and lower quality of life. Y. LHL represents nearly 50% of Germans. In Germany, every fourth to fifth person is not immunized against COVID-19. Z. According to a Waystar (Health Care Billing Software) report from 2019, nearly 40% of healthcare consumers were unaware that the cost of their healthcare varied across facilities.