How does health literacy affect health in adults with asthma?

Low health literacy is common, especially among those with low socioeconomic status, the elderly, and those whose primary language is not English, reflecting limited educational opportunities. The severity and complexity of asthma tends to be high in these same patients. One theory explaining poor asthma outcomes among disadvantaged patients is that health literacy affects their ability to manage one or more health problems like asthma.

In this study, published in The Journal of Allergy and Clinical Immunology (JACI), Apter et al examine how health literacy is related to asthma self-management. Patients with moderate-severe asthma were recruited from clinics serving low-income urban neighborhoods. Health literacy was measured by a standard test of reading and understanding medical information (print literacy) and a test of numerical concepts needed for patient to manage asthma (numeracy). Then participants’ subsequent management of medications, measured as electronically recorded use of inhaled steroid medication, and asthma status were assessed prospectively for 26 weeks. Two hundred eighty-four patients participated in the study. The average age was 48, most were female, most were African American, and baseline measurement of lung function (FEV1) showed moderately severe asthma. Almost one third had been hospitalized and more than half had required an Emergency Department visit for asthma in the previous year. Most patients had adequate reading scores and answered between 2 and 3 out of 4 numeracy questions correctly. On average patients took about 66% of prescribed inhaled steroid doses during the study.

Higher health literacy scores, whether measured as numeracy or print literacy, were associated with better adherence to prescribed medication, fewer symptoms, and better quality of life from asthma when controlling for age and sex. These associations were diminished somewhat when adjusting for race/ethnicity that was highly correlated with household income and educational status. That is, the effect of minority status which was associated with poorer outcomes could not be separated from the effect of poverty and limited educational opportunities on asthma outcomes.

This study shows the relationship between literacy and health is complex and supports the importance of considering health literacy when clinicians communicate with patients. Finding ways to account for and address the literacy needs of patients may improve asthma outcomes. In the long-term addressing poverty and educational opportunities is essential for better health.

Reference information: www.aaaai.org/

The information aims to provide educational purpose only. Anyone reading it should consult physician before considering treatment and should not rely on the information above.

Symptoms of Allergic Reactions to Foods

Reference information: www.aaaai.org, www.allergy.hk

Symptoms of allergic reactions are generally seen on the skin (hives, itchiness, swelling of the skin). Gastrointestinal symptoms may include vomiting and diarrhea. Respiratory symptoms may accompany skin and gastrointestinal symptoms, but don't usually occur alone.

Severe Allergic Reactions

Anaphylaxis (pronounced an-a-fi-LAK-sis) is a serious allergic reaction that happens very quickly. Without immediate treatment-an injection of epinephrine (adrenalin) and expert care-anaphylaxis can be fatal. Follow-up care by an allergist/immunologist, often referred to as an allergist, is essential.

Symptoms of anaphylaxis may include difficulty breathing, dizziness or loss of consciousness. If you have any of these symptoms, particularly after eating, seek medical care immediately (call 999). Don't wait to see if your symptoms go away or get better on their own.

Diagnosis

An allergist is the best qualified professional to diagnose food allergy. Your allergist will take a thorough medical history, followed by a physical examination. You may be asked about contents of the foods, the frequency, seasonality, severity and nature of your symptoms and the amount of time between eating a food and any reaction.

Allergy skin tests may determine which foods, if any, trigger your allergic symptoms. In skin testing, a small amount of extract made from the food is placed on the back or arm. If a raised bump or small hive develops within 20 minutes, it indicates a possible allergy. If it does not develop, the test is negative. It is uncommon for someone with a negative skin test to have an IgE-mediated food allergy.

In certain cases, such as in patients with severe eczema, an allergy skin test cannot be done. Your physician may recommend a blood test. False positive results may occur with both skin and blood testing. Food challenges are often required to confirm the diagnosis. Food challenges are done by consuming the food in a medical setting to determine if that food causes a reaction.

The information aims to provide educational purpose only. Anyone reading it should consult physician before considering treatment and should not rely on the information above.