A physician new to Salisbury shared a statistic this week that had people shaking their heads in disbelief. He may have been more accurate than many people want to believe.

Dr. Jack Byrnes, director of the Emergency Department at Novant Health Rowan Medical Center, said many of the patients he sees in the ER have trouble reading discharge papers. That reflected the fact that 25 percent of the Rowan’s 18 and older population is illiterate, he said.

That was one figure among dozens Byrnes shared on a wide range of health and demographic issues, and it did not come up in the question-and-answer period at the end of his talk. But the question of literacy vs. illiteracy is worth exploring.

The National Assessment of Adult Literacy found 15 percent of Rowan County’s estimated 99,665 people 16 years and older lacked basic prose literacy skills in 2003, the last time an assessment was done. That means some 15,000 people would have trouble comprehending a printed news story or following written instructions. It does not mean that they were completely illiterate. Today’s literacy statistics are more along the lines of “functional illiteracy” than the inability to read anything at all. They also include people who may read quite well but not in English.

Because of the margin of error in the study done by the National Assessment of Adult Literacy, the possible range for Rowan was 7.3 to 24.8 percent. By comparison, the state rate was 14 percent, with a range of 11-16.5 percent.

Rowan’s 15 percent figure from 2003 was an improvement from what the study found in 1992 — 19 percent lacking basic prose literacy skills.

Health literacy is tougher still. It requires not only basic reading skills, but also the ability to:

• Understand oral communication. (What did the doctor say?)

• Use numbers and math skills.

• Understand how to navigate the health system on a basic level

• Communicate with health care providers and their staff.

Lacking in any of those areas means a person could have trouble describing health problems, reading prescription bottles and warning labels, managing care at home and — the biggie — understanding health insurance.

The need for strong literacy skills goes well beyond determining what kind of job you can get. It could even influence your health — and how well you understand the doctor if you get sick.