“We had no idea when we started where this would go. We just had commitment,” says Ruth Murphey Parker about the decades-long work she has done to improve health literacy. One marker of success is that her definition of health literacy — a term that didn’t exist before her efforts began — is incorporated in the Affordable Care Act.

Parker, the recipient of this year’s Jefferson Award — given “to a faculty member or administrative officer for significant service to the university through personal activities, influence and leadership” — is professor of medicine and pediatrics at the Emory School of Medicine and professor of epidemiology at Rollins School of Public Health.

Coming from a family she describes as “adventuresome in spirit,” Parker was in the first class of women at Davidson College. To her, it was an unparalleled education because it embodied Albert Einstein’s idea that “all religions, arts and sciences are branches of the same tree … directed toward ennobling man’s life.”

Attending the University of North Carolina at Chapel Hill for her medical degree, Parker graduated 100 years to the day after her great-grandfather, T. B. Davis, became the family’s first physician. She did her residency at the University of Rochester School of Medicine and then joined the Robert Wood Johnson Foundation’s Clinical Scholars Program at University of Pennsylvania.

Family has figured in large ways in the course of Parker’s career. When her mother developed breast cancer during Parker’s time at Penn, she wanted to return to the Atlanta area, having been raised in Newnan. 

Setting her own course

Parker went to work at Grady Memorial Hospital, an institution she reveres for its commitment to the underserved. Her work began with a clinical focus, but she remembers thinking, “My gosh, I can do anything here.” 

Parker admits that she “loved asking questions.” And within her first two years at Grady, questions were bubbling up. As she recalls, “I was trying to understand who our patients were.”

Parker hired 64 medical students to survey everyone who walked into the emergency room over seven days. Shortly thereafter, a follow-up survey about the long wait times for ER patients led to an unexpected finding — perhaps as many as one-third of patients struggled to read the simple survey. This news rocked Parker, who wondered, “what are they doing with their pill bottles and appointment slips, and why don’t we practice medicine in a way that addresses this situation?” 

Given the Robert Wood Johnson Foundation connection, Parker placed her first call there. The project officer advised: “If you are right, this is huge.”

Parker laughs that some of her contacts came out of the Yellow Pages, but she was passionate about what needed to be done and not shy about asking for help. She and others quickly created a tool to measure health literacy and conducted the first national health literacy survey of patients, confirming the disturbing percentage of patients with low health literacy: one-third.

As she lobbied to increase health literacy, she found supporters she might not have expected. Parker credits organized medicine with embracing the initiative. Even big pharma stepped up, with Pfizer putting millions of dollars into the effort.

Never hesitant to turn the mirror back on the health care profession when it is warranted, Parker has helped her students over the years see medical ethics differently. Adam Carlisle was a Vanderbilt University undergraduate in a class Parker taught, a medical student here and Parker’s teaching assistant. Now assistant director of cardiovascular quality at Piedmont Heart Institute, he describes the field before and after Parker.

“Medical ethics were traditionally taught by the two physicians with the most extreme opinions trying to defend how they failed when caring for patients in the past. Patients rarely benefited. Ruth led a number of us to commit to do the right thing for patients before we were faced with hard challenges of patient care,” he says.

It is no surprise to hear that, in Parker’s view, the largest contributors to the evolution of health literacy were patients. “Patients were struggling and ashamed but willing to let us put a face on the problem. I have such gratitude for their courage and what they taught us,” she says.

In 2004, Parker and colleagues worked with the Institute of Medicine (now National Academy of Medicine) to issue a landmark report titled “Health Literacy: A Prescription to End Confusion,” which made recommendations for addressing the nation’s health literacy. The report explained that reducing disparities, improving quality and decreasing costs all require health literacy. Her research helped anchor a national platform for recommending how to rectify gaps in patient understanding.

“Through her seminal work on the landmark report and her work with the Roundtable on Health Literacy at the National Academies of Sciences, Engineering and Medicine, Ruth has done more than anyone I know to make health care comprehensible, actionable, and effective for patients who most need help,” says Rose Marie Martinez, director of the National Academies’ Board on Population Health and Public Health Practices.

Medicine and compassion

The young Davidson co-ed so passionate about science and the humanities has found a new outlet. In 2000, Parker was asked by Emory faculty member Judy Raggi Moore to create and teach a course for undergraduates in Moore’s popular Emory Italian Studies Summer Abroad program. For 16 years, Parker taught the course Medicine and Compassion in Italy to a total of 250 students.

Arian Hatefi, senior health specialist at the World Bank Group, took the Italy course as an undergraduate, later served as Parker’s teaching assistant, and has collaborated with her on projects since graduating. “When ‘the secret to caring for the patient is caring for the patient,’ Ruth shines as the brightest example of what a physician, educator, mentor and role model should be,” he says.

With Moore now retired, Henry Bayerle, associate professor of classics at Oxford College, is her study abroad partner and coauthor on multiple articles. He extends to Parker what she would consider the highest praise of all.

“Ruth is well known for her collaboration with colleagues in humanities. But she is more than a collaborator; she is a humanities scholar and teacher in her own right,” he says.