One of the biggest problems that health care providers have to deal with pertains to health literacy, which is a person’s ability to understand health care information and navigate the health care system. Currently, health literacy in the United States is woefully deficient.

So what exactly is health literacy?

There are many definitions out there, but the concept behind them is essentially the same. An example comes from the American Medical Association Foundation, which defines health literacy as: “the ability to obtain, process and understand basic health information and services needed to make appropriate health decisions and follow instructions for treatment.”

The Center for Health Care Strategies puts it more simply. In their definition, health literacy refers to “the skills necessary for an individual to participate in the health care system and maintain good health.” The skills they identify are reading and writing, calculating numbers, communicating with health care professionals, and using health technology such as electronic diabetes monitors.

The Network for the National Library of Medicine agrees that health literacy involves using a certain set of skills. The network suggests that “health literacy requires a complex group of reading, listening, analytical and decision-making skills, as well as the ability to apply these skills to health situations.”

According to the US Centers for Disease Control and Prevention (CDC), anyone who needs health information and services also needs health literacy skills. You can use those skills to find appropriate information and services, communicate your needs and preferences, and respond to the information and services.

Health literacy skills also enable you to understand the choices, consequences, and context of the information you receive. With such understanding, you can make decisions based on which information and services match your needs and preferences.

But there’s a big problem. An estimated 90 million Americans, nearly 36 percent, have low health literacy. And it affects certain populations more than others.

For example, Hispanic adults have lower health literacy skills overall than any other ethnic or racial group. Low health literacy is also more common in people who speak another language or speak English as a second language, as well as in older people, people with lower socioeconomic status or education, and people who are uninsured or on Medicare or Medicaid.

It’s imperative that we improve health literacy in this country because low health literacy is having a negative effect on how Americans use the health care system and on overall health outcomes. And as a result of increased use of services and poor outcomes, low health literacy is making an enormous impact on the nation’s health care costs.

The authors of a report titled “Low Health Literacy: Implications for National Health Policy” estimate the impact of low health literacy on the nation’s economy to be between $106 billion and $238 billion annually. That amount, the authors point out, represents between 7 percent and 17 percent of all personal health care expenditures.

To achieve optimal health, you must be an active participant in your health care. But people with low literacy often don’t have the skills necessary to clearly describe their symptoms to their health care provider, or fully understand their diagnosis and follow the instructions for their treatment. Many are simply unable to play an active role in their care.

And that affects the way they use the health care system. Many avoid going to the doctor, and when they have a health concern, they go to the emergency room for care instead. Studies show that people with low health literacy are 2.3 times more likely to visit the emergency room. And with that comes an associated increase in hospital admissions.

Health literacy affects overall health and mortality as well. Low health literacy has been linked to increased frequency of depression, physical limitations, and chronic diseases such as heart disease, stroke, diabetes, and asthma.

Making matters worse, people with low health literacy often have little understanding of their chronic disease. And because they are less engaged in their health care, they are less likely to use preventive services or follow instructions for managing their chronic disease. As a result, people with low health literacy have a much higher risk of complications and death.

Health care providers, health educators, and patients all have roles to play if we’re going to boost health literacy in America. Patients must be willing to engage with their providers and listen to what they say. Providers and educators can do their part by following these Four Simple Strategies for Improving Your Patients’ Health Literacy:

• Use plain language in both verbal and written communication
• Use visual aids
• Recommend and use technology – Research shows that nearly 90 percent of Americans use the internet and 81 percent own a smartphone. Using these technologies can be a good way for providers to get their message to patients.
• Use effective teaching methods – Some techniques include talking slowly, asking open-ended questions, and asking patients to repeat instructions given to them.

Why is health literacy important? It’s important because it allows you to make good decisions about your health. Health literacy also enables you to get appropriate medical care, take your medications correctly, and manage chronic diseases. And most importantly, it helps you lead a healthy lifestyle so you can live a full and healthy life.

Florida’s has long been referred to as “The Sunshine State,” but anyone who sees the proverbial glass as being half-empty instead of half-full would be justified in calling it “The Lightning State.”

With an average of more than 3,000 lighting strikes per day and more than a million lightning strikes per year, Florida ranks fourth in the nation behind Texas, Oklahoma and Kansas in the number of recorded lightning flashes each year.

However, because of its vast population and the fact many of its residents and visitors spend a good deal of their time outdoors, Florida traditionally ranks first in the nation each year in the number of lightning-related deaths and injuries.

That’s the bad news. The good news is that due to an increase in awareness regarding this potentially instant killer, the number of deaths attributed to lighting strikes in the state of Florida has been on the decline in recent years.

Since 2001, when the National Lightning Safety Council launched its first National Lightning Safety Awareness Week, the number of deaths attributed to lightning nationally has been cut almost in half, from about 50 a year to about 30 per year.

That’s still too many, of course, which is why the National Lightning Safety Council continues its effort to educate people regarding lighting and its dangers, particularly here in the state of Florida.

In accordance with the National Weather Service, the National Lightning Safety Council reminds us that if you are outdoors and in a place where you can hear thunder, then you are in a place where you could be struck by lightning.

Simply put, there is no safe place outside when thunderstorms are in the area. That’s why the National Weather Service has come up with the motto, “When Thunder Roars, Go Indoors!”

Of course, heading indoors when thunder roars is sometimes easier said than done. For those situations when immediately heading indoors is not possible, it’s good to keep a few simple safety rules regarding thunder and lightning in mind.

To minimize the potential of injury when lightning is in the area, it’s best to stay away from wide open areas such as fields, hilltops and parking lots. It’s also best to stay as far away as possible from tall trees, even when in the woods.

You also want to stay away from standing water and avoid handling or touching anything that may be wet such, especially golf clubs, tools and metal fences or poles because water and metal are conductors of electricity.

These simple steps can greatly decrease a person’s chances of being struck by lightning, but if someone is struck, there is no need to fear touching the victim because lightning victims do not carry an electrical charge.

Should someone around you be struck by lightning, call 911, monitor the victim as best as possible and perform CPR if necessary until professional help can arrives to attend to the victim.

Medical theories abound over what caused the great master to leave so many works, including his most famous, undone?

For all of its beauty, mystery and technical expertise, the Mona Lisa has long been considered an unfinished masterpiece. It remains a subject of debate even today, and not just among artists and art historians, but among medical professionals as well.

In early May, as the art world began to recognize the 500th anniversary of the death of the Mona Lisa’s creator, Leonardo da Vinci, several doctors began questioning the long-standing beliefs regarding da Vinci’s failure to complete the work, which was first discovered in his studio immediately after his death.

One of those beliefs is that da Vinci suffered a stroke that robbed him of the use of his right hand, which is the hand the ambidextrous artist painted with. Another suggests da Vinci’s right hand became deformed as a result of a condition known as Dupuytren’s contracture.

Two Italian physicians – one a plastic surgeon, the other a neurologist – were the first to question those theories, arguing in The Journal of the Royal Society of Medicine that da Vinci may have simply suffered a fall that resulted in nerve damage to his right hand.

They based their theory on a drawing created by a contemporary of an elderly da Vinci in which da Vinci’s right arm is wrapped in “folds of clothing, as if it was a bandage, with his right-hand suspended in a stiff, contracted position.”

The doctors go on to say that, in the drawing, da Vinci’s right hand does not appear to be gnarled or clenched in the way that it would have been had it been disabled by a stroke and otherwise suggest the disabling cause may have been a palsy known as claw hand.

The authors used another drawing, this one a 1505 depiction of a man identified as an older da Vinci playing a lyre, to rule out Dupuytren’s contracture as the cause of the late-life disability in da Vinci’s right hand.

Dupuytren’s contracture is a progressive disease that gnarls the hand slowly over time. The authors argue that if da Vinci suffered from the disease, its symptoms would have been present in the 1505 drawing, which they are not.

The art world was still digesting the two Italian author’s findings when, in late May, a paper published in the journal Brain suggested yet another reason why da Vinci continued to teach and draw until his death but left many paintings unfinished.

According to Marco Catani, a King’s College of London psychiatrist, and Paolo Mazzarello, a medical historian at the University of Pavia, da Vinci suffered from attention deficit and hyperactivity disorder, or ADHD, and was a chronic procrastinator who struggled to finish projects.

“Even when Leonardo was finally commissioned with the important project of building a bronze statue of Ludovico’s father, the future Duke asked his allied Lorenzo il Magnifico if he could indicate a more apt Florentine artist for the project because he ‘doubted Leonardo’s capabilities to bring it to completion.’”

Catani and Mazzarello used accounts of da Vinci’s behavior and work habits culled from writings about da Vinci in reaching their conclusion, noting that da Vinci struggled to remain focused on tasks from early childhood on.

They refer to stories of how da Vinci regularly wowed people with his ambitious ideas and projects but often disappointed them because he failed to complete the project he was hired to do. A statue of the father of Ludovico il Moro, the future Duke of Milan, was one such project.

“Even when Leonardo was finally commissioned with the … project … the future Duke asked … if …  a more apt Florentine artist (could be found) because he doubted Leonardo’s capabilities to bring it to completion,” Catani and Mazzarello wrote.

The authors go on to suggest that evidence of ADHD can be found in the history behind the creation of other great works by da Vinci, including The Last Supper, which is painted on a wall in the dining hall of the Santa Maria delle Grazie in Milan, Italy.

They also suggest that ADHD negatively affected da Vinci’s relationships, career and income, but they note that it may have been at the root of his virtually unsurpassed creativity and imagination.

“The difficulties linked to his extraordinary wandering mind caused him deep regrets but did not prevent him from learning and exploring the wonders of human life and nature,” the authors wrote.