According to the U.S. Department of Health and Human Services, health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. It is dependent on a number of personal and institutional factors, including communication skills, extent knowledge and experience, culture, opportunity for learning, and access to healthcare.

Only 12 percent of American adults, or about one out of ten, have competent health literacy. So every medical professional deals with the fact that almost nine out of ten adults may lack the skills needed to manage their health. More than 30 million adult Americans, or 14%, don’t have even basic health literacy.

Health literacy affects one’s ability to navigate the healthcare system, including filling out complex forms and locating providers and services, properly share personal health information and history, and understand diagnoses and treatment plans. The lower the level of health literacy, the less likely the patient is to have health insurance.

Health literacy also includes math skills. For example, calculating cholesterol and blood sugar levels, measuring medications, and understanding nutrition labels all require math skills, not to mention being able to compare prescription drug coverage or calculate co-pays and deductibles.

While this affects every medical practice, it touches radiology in specific and significant ways that should be considered in most major decision making processes. Radiology is one of those fields that suffers from tremendous social misunderstanding. Way back when, radiology wasn’t as safe as it is now. Some people still conflate modern radiology with dangerous nuclear fallout from wartime bombs, especially older Americans.

A 2015 study, for example, showed that parents with low health literacy are less apt to ask for or give permission for radiological testing. People with low and limited health literacy often also believe misinformation about the body as well as the nature and causes of disease.

Many people turn to the internet for information before a radiological procedure. But another recent study found that information about some cardiac vascular and interventional radiology procedures on radiological practice websites was written at the 12th grade level, while health literacy educational materials are recommended to be written at the 7th grade level.

Patients with limited health literacy have been shown statistically to be less prepared for diagnostic examinations, and as a result, tend to have examinations of poorer diagnostic quality.

MRTs play a vital role in educating patients about medical imaging exams, and helping them to prepare for these procedures. Radiologists and their staff should conduct short interviews with all patients before any exam, using simple, plain language and questions that can be answered with “yes” or “no” or just a few words, to find out if they prepared properly.

When patients need to conduct their own follow-up care, instructions can be delivered using the “teach back” method, when patients are asked to repeat back their instructions. This has been shown to greatly improve comprehension and adherence.

Health information can overwhelm even people with advanced literacy skills, especially in stressful situations like health crises. Taking a little time to talk beforehand can result in exams of higher diagnostic quality, and by extension, to better health outcomes.