Many professionals in the dark on women's health disparities

May 1, 2005

A dearth of adequate knowledge about women's health —shared by pharmacists, physicians, and patients alike—is costing our healthcare system $58 billion a year, according to a 2004 report by the Institute of Medicine. The report, entitled "Health Literacy: A Prescription to End Confusion," states that nearly half of American adults, or 90 million people, have difficulty understanding and acting upon health information.

A dearth of adequate knowledge about women's health -shared by pharmacists, physicians, and patients alike-is costing our healthcare system $58 billion a year, according to a 2004 report by the Institute of Medicine. The report, entitled "Health Literacy: A Prescription to End Confusion," states that nearly half of American adults, or 90 million people, have difficulty understanding and acting upon health information.

Those kinds of statistics are a result to some degree of the fact that many healthcare professionals, including pharmacists, lack an awareness of the particular health literacy and medical problems facing women, said Sunil Kripalani, M.D., a health literacy researcher and assistant professor of medicine at Emory University's school of medicine in Atlanta. "Most physicians assume that their patients understand healthcare information and instructions," he said. "If anything, we should assume the opposite."

Healthcare literacy is defined by the Harvard School of Public Health as a patient's capacity to obtain, process, and understand the health information and services needed to make appropriate decisions. It applies to professionals and patients, and certainly does not reflect an inability to read and write.

Much information is emerging about the differences in how men and women metabolize medications, as well, noted Rosaly Correa-de-Araujo, M.D., a researcher with the Agency for Healthcare Research & Quality. "A woman's response to medications may change according to her stage in life, and hormones have been blamed for this," she said, "so it's critical that women across all life stages be alerted to the benefits and risks of medications and their proper use."

Increased literacy about women's health can reduce medical errors, according to researchers at the Institute for Safe Medication Practices in Huntington, Pa. Pharmacists and physicians can help reduce medication errors by being more aware of the ways in which drugs affect women differently from men. "Although medication errors are not more common in women, there are some unique concerns with medications used for treating women," said Matthew Grissinger, R.Ph., an ISMP researcher. For example, he noted, women react differently to many pain medications. Pharmacist awareness of those concerns can reduce errors, he added.

Part of the literacy problem lies in inadequate dissemination of information, said Doyle Cummings, Pharm.D., a professor of family medicine at the Brody School of Medicine at East Carolina University in Greenville, N.C. Cummings, who is a leading expert in hormone replacement therapy, commented that although there is a "great deal of information out there about HRT, it can get confusing. It can leave many professionals as well as patients unsure about the best treatment."

According to the National Women's Health Resource Center (NWHRC) in Red Bank, N.J., studies have found that women with low health literacy are hospitalized more often, have more difficulty using metered-dose inhalers for asthma and other lung conditions, and, if they have diabetes, have poorer HbA1c levels than women with higher health literacy levels

Overall, medical professionals apparently do a poor job communicating with their women patients. A study of nearly 1,000 women with breast cancer found that nearly half said the information they received on several medical aspects of their condition was "incomprehensible or incomplete," according to the NWHRC.

Greenberger recommends that professionals avail themselves of the special programs addressing disparities in women's health conducted by various professional medical organizations, such as the American Heart Association. "Much of this is totally new to many professionals," she said. "But help and information are available, if they are sought."