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Health Literacy: the forgotten social determinant of health?

Mrinalini Dey, MBBChir, MA(Hons) Cantab., MRCP, FHEA Nov 17, 2024

Nine out of ten adults in the USA struggle to understand basic health-related information. Across the pond, in the UK, 7.1 million adults read at, or below, the level of a nine-year-old, with 60% unable to understand health information. An increasing body of research in rheumatic diseases has sought to understand the impact of health literacy, long neglected as a social determinant of health, on clinical and non-clinical outcomes. Several abstracts at this year’s ACR Convergence focus on this topic.

What do current national/international rheumatology association guidelines say about perioperative discontinuation of biologics? it's highly, highly variable no wonder people get confused! #ACR24 ABST1037 @CatherineL_Hill @RheumNow https://t.co/cmJ3qKU1QT

https://x.com/drdavidliew/status/1858182160169242882/photo/1

Positive impacts of registry participation across outcomes. #ACRBest #ACR24 @RheumNow https://t.co/BgaNLfHaF1

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How do you treat a flare of SLE with steroids? @RheumNow #ACR24

Petri: 5 mg prednisone or less is our standard for lupus control EULAR 23 recs - early addition of immunosuppressant and/or biologics instead to prevent steroids @RheumNow #ACR24 @jhrheumatology https://t.co/jhxEeboPu5

At "Envisioning a Steroid Free Future" talk Angelo Gaffo at the mic: "Are there any situations you would do induction therapy for AAV without steroid?" John Stone: [pause] "No." 😄 #ACR24 @RheumNow

Reset the bar for remission (off steroids)!! Session #17S19 3% higher risk of organ damage for each 1mg of pred Remission possible in rheum with lower dose GC regimen and faster taper #GCStewardship #ACR24 @RheumNow @BethIWallace

In case you needed more encouragement for recombinant zoster vaccination in RA patients: it prevents herpes zoster episodes, in the real world. RA pts in KP system n=1926 vaccinated matched 1:3 with non-vaccinated - HZ reduced 60% - PHN reduced 88% #ACR24 ABST0977 @RheumNow https://t.co/BryBrlv9K5

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Give a listen to my @RheumNow interview w Josh Hsieh, a rising star at #ACR24, who is presenting his first (of many) research project as a high school sophomore! His work w @NamrataRheum explores what is known- & not yet known- for cancer survival in RA https://t.co/boqwpP9CUK https://t.co/UQ37pyvZT6

#1456 💥In a real-world UK PsA cohort, 25% had joint erosion @ diagnosis ➡️Mean disease duration 34mo. @ diagnosis ➡️Mean disability score = mod. to severe 💥Delay in diagnosis=poor outcomes ‼️Are we doing enough to catch PsA early? ? 🔑Earlier detection key #ACR @RheumNow

#1375🏋️‍♀️ Strength Training in RA ➡️ 12-week trial 28 ♀️ High-intensity(HIRT) v. Low-intensity+blood flow restriction(LIT-BFR) 🔴Equivalent gains:Lat-pulldown, biceps curl 🔴Knee extension:HIRT>LIT-BFR (non-significant) ✅ LIT-BFR: Alternative for RA sarcopenia #ACR24 @RheumNow

Is participation in RISE assoc with improved quality of care? ➡️Enrolment assoc w ⬆️performance in several quality measures ➡️Most marked in practices with lower baseline performance ⏩Registry participation has potential to improve quality of rheum care Ab1644 #ACR24 @RheumNow

What’s on tap for Trump health care agenda? Uncertainty as to what priorities and actions will be ACR has plans to address legislative, regulatory, and state affairs @ACRheumDC #ACR24 @RheumNow https://t.co/a5z4RIOjRC

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A meta-analysis of 11 randomized trials shows no significant difference in efficacy of bDMARDs for early vs. established axial spondyloarthritis (axSpA). Treating at different stages yields comparable short-term outcomes. Abstr#1468 #Spondyloarthritis #RheumatologyResearch… https://t.co/QYuTcVj2m1 https://t.co/ADzEEbCvUM

@ACRheumDC State Update: No changes at executive level Some shifts in state legislation With political changes and new administration, states will probably take larger role in healthcare legislation - PBM reform, copay accum, prior auth/step, reprod healthcare @RheumNow #ACR24 https://t.co/jc77HCLxqQ

State Update @ACRheumDC No executive level changes, some state legislative flips Political changes will likely lead to more state legislative healthcare legislation - In the works for PBM reform, copay accum, prior auth/Step, reprod healthcare @RheumNow #ACR24 https://t.co/94KyHU0Blr

What is Osteoarthritis? A downloadable patient education page from JAMA. https://t.co/pQgGfI0boe https://t.co/pd3kygUxkH

Patient Information: Knee Osteoarthritis

119 Congress - prepare for change Obamacare subsidies set to expire NIH changes and possible reorg ACR champions are in gov positions for both parties Focus on affecting change that is practical, possible and improves rheumatology practice @ACRheumDC @LennMcD @RheumNow #ACR24 https://t.co/tcxixdlSWQ

@LennMcD @ACRheumDC Do policies affect medication access, costs, reimbursements, telehealth, or your life as a rheumatology provider or patients? Contact - quick and easy! https://t.co/TvMlXiIZQR @RheumNow #ACR24 https://t.co/plnUtl7Kml https://t.co/lFGx7hzlKy

#Blinded by results? 😊 #Ocular #involvement in #GPA 👇 Helped by #rituximab 👁️ #GPA Difficult Proptosis Pseudotumour Conjunctivitis Scleritis Vasculitis Ocular muscles - diplopia Small case series ‘author defined’ remission in 80% 👍 #RTX #abst0726 @rheumnow #ACR24 https://t.co/GHptelOTyv

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Health Literacy: the forgotten social determinant of health?

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