Fixing healthcare in America begins with growing good readers

Reading is an essential building block of learning — but it may come as a surprise to many that reading proficiency is one of the strongest predictors of overall health through adulthood. Much of the conversation about literacy is focused on the economic impact of decreased worker productivity and lost income. In doctor’s offices and health systems across our country, we see first-hand the effect of reading challenges on our patients and its lifetime impact on health outcomes.  The relationship of literacy to health outcomes and expenditures is real, with a conservative annual estimated price tag of more than $106 billion. 

In the United States today, thirty to forty percent of children are at risk for reading failure before they reach kindergarten. As a physician and the CEO of a children’s health system, I am encouraged by the bipartisan support for addressing reading failure for early learners contained within S.1177, the Every Child Achieves Act of 2015.

{mosads}This pivotal legislation includes several important provisions for quality early childhood education that are the foundation of improving reading readiness, providing health education, and ensuring our children have a strong and healthy start in life. These programs are highly cost effective with an average return on investment for every dollar spent of seven to ten dollars in averted costs related to special education, grade retention, health care, welfare, and crime. Changing the cost equation in our healthcare system over the long-term begins with our children and starts at infancy. 

Good readers have confidence that they are smart and are motivated to do their best each day in school, building a foundation for life-long self-esteem and productivity. Struggling readers often have bright minds that just learn differently, but they lose their confidence without proper support. Our experience with reading readiness through our Nemours BrightStart! program shows that when the needed supports are available starting in pre-kindergarten, an investment of as little as 12 hours can help struggling readers catch up with their peers.  

Reading challenges can be a source of childhood maladies for which parents seek medical care and testing, presenting as a child’s withdrawal in class, lack of focus, headaches, stomachaches, fatigue and anxiety.  Nemours supports S.1177  not only because it will provide high-quality early learning opportunities for children that include early intervention for reading challenges, but also education and exposure to healthy foods and exercise, which together build  lifelong skills and habits necessary for good health. 

The relationship of literacy to health outcomes and expenditures is real and it’s costly. Patients with low literacy skills are less likely than their counterparts to seek preventative care, have difficulty complying with their prescribed course of treatment, have greater likelihood of not taking medication properly, and are more likely to be hospitalized. From making and keeping an appointment, to understanding how to follow your doctor’s instructions, reading proficiency is crucial to accessing quality care, improving overall health outcomes, and closing the gap on health disparities in the United States.  

The Every Child Achieves Act, along with public and private partnerships, is essential to improving educational and health outcomes for all children.  Without these efforts, the children of today, for the first time in two centuries, are heading for a shorter life expectancy than their parents.  Together, we can all do our part to reverse this unacceptable trend.  

Bailey ispresident & CEO of Nemours Children’s Health System.


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