Health literacy
Health literacy is the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment. There are multiple definitions of health literacy, in part, because health literacy involves both the context (or setting) in which health literacy demands are made (e.g., health care, media, internet or fitness facility) and the skills that people bring to that situation (Rudd, Moeykens, & Colton, 1999). Studies reveal that only 12 percent of the adults in the U.S. have proficient health literacy. This means 77 million adults have basic or below basic health literacy. These individuals have difficulty with common health tasks including reading the label of a prescribed drug. Low health literacy reduces the success of treatment and increases the risk of medical error. Health literacy is essential to promote healthy individuals and communities.
Various interventions, such as simplifying information and illustrations, avoiding jargon, using "teach-back" methods, and encouraging patients' questions, have improved health behaviors in persons with low health literacy. Since health literacy is a primary contributing factor to health disparities, it is a continued and increasing concern for health professionals. The proportion of adults aged 18 and over in the U.S., in the year 2010, who reported that their health care providers always explained things so they could understand them was about 60.6%. This number increased 1% from 2007 to 2010. The Healthy People 2020 initiative of the United States Department of Health and Human Services has included health literacy as a pressing new topic, with objectives for improving it in the decade to come.
Society as a whole is responsible for improving health literacy. Most importantly, improving health literacy is the responsibility of healthcare and public health professionals and systems.
National Action Plan to Improve Health Literacy
The National Action Plan to Improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked, multi-sector effort to improve health literacy. The Action Plan is based on 2 core principles:
The Action Plan contains 7 goals that will improve health literacy and strategies for achieving them:
Many of the strategies highlight actions that particular organizations or professions can take to further these goals. It will take everyone working together in a linked and coordinated manner to improve access to accurate and actionable health information and usable health services. By focusing on health literacy issues and working together, we can improve the accessibility, quality, and safety of health care; reduce costs; and improve the health and quality of life of millions of people in the United States.
What is health literacy?
Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
Health literacy is dependent on individual and systemic factors:
Health literacy affects people's ability to:
Health literacy includes numeracy skills. For example, calculating cholesterol and blood sugar levels, measuring medications, and understanding nutrition labels all require math skills. Choosing between health plans or comparing prescription drug coverage requires calculating premiums, copays, and deductibles.
In addition to basic literacy skills, health literacy requires knowledge of health topics. People with limited health literacy often lack knowledge or have misinformation about the body as well as the nature and causes of disease. Without this knowledge, they may not understand the relationship between lifestyle factors such as diet and exercise and various health outcomes.
Health information can overwhelm even persons with advanced literacy skills. Medical science progresses rapidly. What people may have learned about health or biology during their school years often becomes outdated or forgotten, or it is incomplete. Moreover, health information provided in a stressful or unfamiliar situation is unlikely to be retained.
Summary
Health literacy refers to how well a person can get the health information and services that they need, and how well they understand them. It is also about using them to make good health decisions. It involves differences that people have in areas such as
More than 90 million adults in the United States have low health literacy. It affects their ability to make health decisions. This can harm their health. They may have trouble managing chronic diseases, and leading a healthy lifestyle. They may go to the hospital more often, and have poorer health overall.
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HEALTH INFORMATION FROM NIH
Health literacy is the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment. There are multiple definitions of health literacy, in part, because health literacy involves both the context (or setting) in which health literacy demands are made (e.g., health care, media, internet or fitness facility) and the skills that people bring to that situation (Rudd, Moeykens, & Colton, 1999). Studies reveal that only 12 percent of the adults in the U.S. have proficient health literacy. This means 77 million adults have basic or below basic health literacy. These individuals have difficulty with common health tasks including reading the label of a prescribed drug. Low health literacy reduces the success of treatment and increases the risk of medical error. Health literacy is essential to promote healthy individuals and communities.
Various interventions, such as simplifying information and illustrations, avoiding jargon, using "teach-back" methods, and encouraging patients' questions, have improved health behaviors in persons with low health literacy. Since health literacy is a primary contributing factor to health disparities, it is a continued and increasing concern for health professionals. The proportion of adults aged 18 and over in the U.S., in the year 2010, who reported that their health care providers always explained things so they could understand them was about 60.6%. This number increased 1% from 2007 to 2010. The Healthy People 2020 initiative of the United States Department of Health and Human Services has included health literacy as a pressing new topic, with objectives for improving it in the decade to come.
Society as a whole is responsible for improving health literacy. Most importantly, improving health literacy is the responsibility of healthcare and public health professionals and systems.
National Action Plan to Improve Health Literacy
The National Action Plan to Improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked, multi-sector effort to improve health literacy. The Action Plan is based on 2 core principles:
- All people have the right to health information that helps them make informed decisions
- Health services should be delivered in ways that are easy to understand and that improve health, longevity, and quality of life
The Action Plan contains 7 goals that will improve health literacy and strategies for achieving them:
- Develop and disseminate health and safety information that is accurate, accessible, and actionable
- Promote changes in the health care system that improve health information, communication, informed decision-making, and access to health services
- Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through the university level
- Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community
- Build partnerships, develop guidance, and change policies
- Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy
- Increase the dissemination and use of evidence-based health literacy practices and interventions
Many of the strategies highlight actions that particular organizations or professions can take to further these goals. It will take everyone working together in a linked and coordinated manner to improve access to accurate and actionable health information and usable health services. By focusing on health literacy issues and working together, we can improve the accessibility, quality, and safety of health care; reduce costs; and improve the health and quality of life of millions of people in the United States.
What is health literacy?
Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
Health literacy is dependent on individual and systemic factors:
- Communication skills of lay persons and professionals
- Lay and professional knowledge of health topics
- Culture
- Demands of the healthcare and public health systems
- Demands of the situation/context
Health literacy affects people's ability to:
- Navigate the healthcare system, including filling out complex forms and locating providers and services
- Share personal information, such as health history, with providers
- Engage in self-care and chronic-disease management
- Understand mathematical concepts such as probability and risk
Health literacy includes numeracy skills. For example, calculating cholesterol and blood sugar levels, measuring medications, and understanding nutrition labels all require math skills. Choosing between health plans or comparing prescription drug coverage requires calculating premiums, copays, and deductibles.
In addition to basic literacy skills, health literacy requires knowledge of health topics. People with limited health literacy often lack knowledge or have misinformation about the body as well as the nature and causes of disease. Without this knowledge, they may not understand the relationship between lifestyle factors such as diet and exercise and various health outcomes.
Health information can overwhelm even persons with advanced literacy skills. Medical science progresses rapidly. What people may have learned about health or biology during their school years often becomes outdated or forgotten, or it is incomplete. Moreover, health information provided in a stressful or unfamiliar situation is unlikely to be retained.
Summary
Health literacy refers to how well a person can get the health information and services that they need, and how well they understand them. It is also about using them to make good health decisions. It involves differences that people have in areas such as
- Access to information that they can understand
- Skills, such as finding that information, communicating with health care providers, living a healthy lifestyle, and managing a disease
- Knowledge of medical words, and of how their health care system works
- Abilities, such as physical or mental limitations
- Personal factors, such as age, education, language abilities, and culture
More than 90 million adults in the United States have low health literacy. It affects their ability to make health decisions. This can harm their health. They may have trouble managing chronic diseases, and leading a healthy lifestyle. They may go to the hospital more often, and have poorer health overall.
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Health Literacy
Definition
Health Literacy is defined in the Institute of Medicine report, Health Literacy: A Prescription to End Confusion, (link is external) as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions."
Health literacy requires a complex group of reading, listening, analytical, and decision-making skills, as well as the ability to apply these skills to health situations. For example, it includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor's directions and consent forms, and the ability to negotiate complex health care systems.
More recent definitions focus on specific skills needed to navigate the health care system and the importance of clear communication between health care providers and their patients. Both health care providers and patients play important roles in health literacy. The number of different definitions for health literacy demonstrate how the field has evolved.
Definitions of Health Literacy“Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”
(Healthy People)
"The term 'health literacy' means the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services in order to make appropriate health decisions."
(Patient and Affordable Care Act of 2010, Title V(link is external))
Health literacy is the use of a wide range of skills that improve the ability of people to act on information in order to live healthier lives. These skills include reading, writing, listening, speaking, numeracy, and critical analysis, as well as communication and interaction skills.”
(Calgary Charter)
Health Literacy in a Cultural ContextRecognizing that culture plays an important role in communication helps us better understand health literacy. For people from different cultural backgrounds, health literacy is affected by belief systems, communication styles, and understanding and response to health information. Even though culture is only one part of health literacy, it is a very important piece of the complicated topic of health literacy. The United States Department of Health and Human Services (HHS) recognizes that "culture affects how people communicate, understand and respond to health information."
There is a move toward "patient-centered" health care as part of an overall effort to improve the quality of health care and to reduce costs. Individual patients and providers need to work together to ensure effective communication. Patients need to take an active role in health related decisions and develop strong health information skills. Healthcare providers need to utilize effective health communication skills. Health educators need to write printed and Web-based information using plain language.
Skills Needed for Health LiteracyPatients are often faced with complex information and treatment decisions. Patients need to:
Oral language skills are important as well. Patients need to articulate their health concerns and describe their symptoms accurately. They need to ask pertinent questions, and they need to understand spoken medical advice or treatment directions. In an age of shared responsibility between physician and patient for health care, patients need strong decision-making skills. With the development of the Internet as a source of health information, health literacy may also include the ability to search the Internet and evaluate Web sites.
Prevalence of Low Health LiteracyAccording to the Agency for Health Care Research and Quality Report, Health Literacy Interventions and Outcomes: an Update of the Literacy and Health Outcomes Systematic Review of the Literature(link is external), low health literacy is linked to higher risk of death and more emergency room visits and hospitalizations. Health literacy may not be related to years of education or general reading ability. A person who functions adequately at home or work may have marginal or inadequate literacy in a health care environment.
People with low health literacy use more health care services, have a greater risk for hospitalization, and have a higher utilization of expensive services, such as emergency care and inpatient admissions. (IOM, 2004(link is external))
Vulnerable populations include older adults, immigrant populations, minority populations, and low income populations.
Reasons for limited literacy skills include:
The relationship between literacy and health is complex. Literacy impacts health knowledge, health status, and access to health services. Several socioeconomic factors impact health status. Literacy impacts income level, occupation, education, housing, and access to medical care. Poor and illiterate people are more likely to work under hazardous conditions or be exposed to environmental toxins.
Economic Impact of Low Health LiteracyIn addition to the effects of low health literacy on the individual patient, there are economic consequences of low health literacy to society. According to the report Low Health Literacy: Implications for National Health Policy "Low health literacy is a major source of economic inefficiency in the U.S. health care system." The report estimates that the cost of low health literacy to the U.S. economy is between $106 billion to $238 billion annually. This represents between 7 percent and 17 percent of all personal health care expenditures. To put this in perspective, the cost represents an amount equal to the cost of insuring every one of the more than 47 million people who lacked coverage in the United States in 2006. Improving health communication reduces health care costs and increases the quality of health care.
Initiatives to Improve Patient CommunicationLow health literacy was once viewed as an individual patient's deficit-that is, a patient's lack of knowledge and skills regarding health issues. We now recognize that health literacy is a "systems issue" (Rudd, 2010), reflecting the complexity of both the presentation of health information and navigation of the health care system. (Parker, Ratzan, 2010)
The Joint Commission, the group that accredits and certifies health care organizations and programs in the United States, stresses the importance of health literacy, health communication, and cultural competencies as an element of quality health care. In their report, What Did the Doctor Say?: Improving Health Literacy to Protect Patient Safety, the Commission states:
Health literacy issues and ineffective communications place patients at greater risk of preventable adverse events. If a patient does not understand the implications of her or his diagnosis and the importance of prevention and treatment plans, or cannot access health care services because of communications problems, an untoward event may occur. The same is true if the treating physician does not understand the patient or the cultural context within which the patient receives critical information... The Joint Commission's accreditation standards underscore the fundamental right and need for patients to receive information - both orally and written - about their care in a way in which they can understand this information.
These landmark reports helped move health literacy from an "under-recognized silent epidemic to an issue of health policy and reform".
Research Findings on the Impact of Low Health LiteracyBelow are just a few of the conclusions from studies on health literacy and outcomes.
Cancer
Role of the Consumer Health LibrarianMany consumer health initiatives are geared towards technological access to health information or rewriting existing health materials at a simpler language level. Both of these approaches are important, but limited. Easy-to-read materials(link is external) and access to technology are only pieces of a process that must be placed in a larger community context.
This may take the form of providing space for meetings, providing health literacy materials, or actively developing health literacy programs. Consumer health librarians can promote awareness of health literacy among health professionals by creating clearinghouses of health literacy information, sponsoring health literacy seminars, and encouraging multi-organizational collaborations.
The National Action Plan for Health Literacy(link is external) identifies the following strategies for health information and library professionals to contribute to health literacy:
Consumer health librarians can also support the direct needs of health information consumers by providing materials that are multilingual, culturally appropriate and easy-to-read, and by developing methods and materials to teach consumers how to evaluate health information resources, especially those found on the Internet.
ReferencesAgency for Health Care Research and Quality (AHRQ). 2011. Health Literacy Interventions and Outcomes: an Update of the Literacy and Health Outcomes Systematic Review of Literature, 2011
American Medical News. Gerontologists outline how doctors can bridge communication gap with older patients
Bennett IM, Chen J, Soroui JS, et al. The contribution of health literacy to disparities in self-rated health status and preventive health behaviors in older adults.(link is external) Annals of Family Medicine, 2009, May-Jun;7(3):204-11.
Centers for Disease Control and Prevention. Older Adults: Why Is Health Literacy Important?
Davis, T. C., Williams, M. V., Marin, E., Parker, R. M., & Glass, J. (January 01, 2002). Health literacy and cancer communication.(link is external) Ca: a Cancer Journal for Clinicians, 52, 3.)
Howard DH, Sentell T, Gazmararian JA. Impact of health literacy on socioeconomic and racial differences in health in an elderly population.(link is external) Journal of General Internal Medicine, 2006, Aug;21(8):857-61.
Institute of Medicine and Nielsen-Bohlman, L., Panzer, A. M., Kindig, D. A., Health Literacy: A Prescription to End Confusion
Joint Commission. (2007). What did the doctor say?: Improving health literacy to protect patient safety. Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations.
Kutner, M., Greenberg, E., Jin,Y., and Paulsen, C. (2006). The Health Literacy of America's Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006-483).U.S.Department of Education.Washington, DC: National Center for Education Statistics.
Paasche-Orlow, M. K., Riekert, K. A., Bilderback, A., Chanmugam, A., Hill, P., Rand, C. S., Brancati, F. L., Krishnan, J. A. (January 01, 2005). Tailored education may reduce health literacy disparities in asthma self-management.(link is external) American Journal of Respiratory and Critical Care Medicine, 172, 8, 980-6.
Parker R, Ratzan SC. Health Literacy: a second decade of distinction for Americans.(link is external) Journal of Health Communication, 2010:15(Suppl 2)20-33.
Rudd, R. Improving Americans' health literacy.(link is external) New England Journal of Medicine, 2010; 363(24):2283-85.
Schillinger D, Grumbach K, Piette J, et al. Association of Health Literacy With Diabetes Outcomes.(link is external) Journal of the American Medical Association. 2002;288(4):475-482. doi:10.1001/jama.288.4.475.
United States Department of Health and Human Services.Office of Disease Prevention and Health
Promotion. Quick Guide to Health Literacy Fact Sheet: Health Literacy Basics.(link is external)Retrieved December 29, 2016.
Vernon, J. A., Trujillo, A, Rosenbaum, S, (2007). Low health literacy: Implications for national health policy.
Weiss, B. D., American Medical Association., & AMA Foundation. (2007). Health literacy and patient safety: Help patients understand. Chicago, Ill: AMA Foundation.
Williams, M. V., Baker, D. W., Honig, E. G., Lee, T. M., & Nowlan, A. (January 01, 1998). Inadequate literacy is a barrier to asthma knowledge and self-care.(link is external) Chest, 114, 4, 1008-15.
White S, Chen J, Atchison R. Relationship of preventive health practices and health literacy: a national study.(link is external)American Journal of Health Behavior, 2008 May-Jun;32(3):227-42.
Definition
Health Literacy is defined in the Institute of Medicine report, Health Literacy: A Prescription to End Confusion, (link is external) as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions."
Health literacy requires a complex group of reading, listening, analytical, and decision-making skills, as well as the ability to apply these skills to health situations. For example, it includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor's directions and consent forms, and the ability to negotiate complex health care systems.
More recent definitions focus on specific skills needed to navigate the health care system and the importance of clear communication between health care providers and their patients. Both health care providers and patients play important roles in health literacy. The number of different definitions for health literacy demonstrate how the field has evolved.
Definitions of Health Literacy“Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”
(Healthy People)
"The term 'health literacy' means the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services in order to make appropriate health decisions."
(Patient and Affordable Care Act of 2010, Title V(link is external))
Health literacy is the use of a wide range of skills that improve the ability of people to act on information in order to live healthier lives. These skills include reading, writing, listening, speaking, numeracy, and critical analysis, as well as communication and interaction skills.”
(Calgary Charter)
Health Literacy in a Cultural ContextRecognizing that culture plays an important role in communication helps us better understand health literacy. For people from different cultural backgrounds, health literacy is affected by belief systems, communication styles, and understanding and response to health information. Even though culture is only one part of health literacy, it is a very important piece of the complicated topic of health literacy. The United States Department of Health and Human Services (HHS) recognizes that "culture affects how people communicate, understand and respond to health information."
There is a move toward "patient-centered" health care as part of an overall effort to improve the quality of health care and to reduce costs. Individual patients and providers need to work together to ensure effective communication. Patients need to take an active role in health related decisions and develop strong health information skills. Healthcare providers need to utilize effective health communication skills. Health educators need to write printed and Web-based information using plain language.
Skills Needed for Health LiteracyPatients are often faced with complex information and treatment decisions. Patients need to:
- Access health care services
- Analyze relative risks and benefits
- Calculate dosages
- Communicate with health care providers
- Evaluate information for credibility and quality
- Interpret test results
- Locate health information
- Visually literate (able to understand graphs or other visual information)
- Computer literate (able to operate a computer)
- Information literate (able to obtain and apply relevant information)
- Numerically or computationally literate (able to calculate or reason numerically)
Oral language skills are important as well. Patients need to articulate their health concerns and describe their symptoms accurately. They need to ask pertinent questions, and they need to understand spoken medical advice or treatment directions. In an age of shared responsibility between physician and patient for health care, patients need strong decision-making skills. With the development of the Internet as a source of health information, health literacy may also include the ability to search the Internet and evaluate Web sites.
Prevalence of Low Health LiteracyAccording to the Agency for Health Care Research and Quality Report, Health Literacy Interventions and Outcomes: an Update of the Literacy and Health Outcomes Systematic Review of the Literature(link is external), low health literacy is linked to higher risk of death and more emergency room visits and hospitalizations. Health literacy may not be related to years of education or general reading ability. A person who functions adequately at home or work may have marginal or inadequate literacy in a health care environment.
People with low health literacy use more health care services, have a greater risk for hospitalization, and have a higher utilization of expensive services, such as emergency care and inpatient admissions. (IOM, 2004(link is external))
Vulnerable populations include older adults, immigrant populations, minority populations, and low income populations.
Reasons for limited literacy skills include:
- Lack of educational opportunity -people with a high school education or lower
- Learning disabilities
- Cognitive decline in older adults
- “Use it or lose it.” Reading abilities are typically three to five grade levels below the last year of school completed. As a result, people with a high school diploma, typically read at a seventh or eighth grade reading level.
The relationship between literacy and health is complex. Literacy impacts health knowledge, health status, and access to health services. Several socioeconomic factors impact health status. Literacy impacts income level, occupation, education, housing, and access to medical care. Poor and illiterate people are more likely to work under hazardous conditions or be exposed to environmental toxins.
Economic Impact of Low Health LiteracyIn addition to the effects of low health literacy on the individual patient, there are economic consequences of low health literacy to society. According to the report Low Health Literacy: Implications for National Health Policy "Low health literacy is a major source of economic inefficiency in the U.S. health care system." The report estimates that the cost of low health literacy to the U.S. economy is between $106 billion to $238 billion annually. This represents between 7 percent and 17 percent of all personal health care expenditures. To put this in perspective, the cost represents an amount equal to the cost of insuring every one of the more than 47 million people who lacked coverage in the United States in 2006. Improving health communication reduces health care costs and increases the quality of health care.
Initiatives to Improve Patient CommunicationLow health literacy was once viewed as an individual patient's deficit-that is, a patient's lack of knowledge and skills regarding health issues. We now recognize that health literacy is a "systems issue" (Rudd, 2010), reflecting the complexity of both the presentation of health information and navigation of the health care system. (Parker, Ratzan, 2010)
The Joint Commission, the group that accredits and certifies health care organizations and programs in the United States, stresses the importance of health literacy, health communication, and cultural competencies as an element of quality health care. In their report, What Did the Doctor Say?: Improving Health Literacy to Protect Patient Safety, the Commission states:
Health literacy issues and ineffective communications place patients at greater risk of preventable adverse events. If a patient does not understand the implications of her or his diagnosis and the importance of prevention and treatment plans, or cannot access health care services because of communications problems, an untoward event may occur. The same is true if the treating physician does not understand the patient or the cultural context within which the patient receives critical information... The Joint Commission's accreditation standards underscore the fundamental right and need for patients to receive information - both orally and written - about their care in a way in which they can understand this information.
These landmark reports helped move health literacy from an "under-recognized silent epidemic to an issue of health policy and reform".
Research Findings on the Impact of Low Health LiteracyBelow are just a few of the conclusions from studies on health literacy and outcomes.
- People with low health literacy have a lower likelihood of getting flu shots, understanding medical labels and instructions, and a greater likelihood of taking medicines incorrectly compared with adults with higher health literacy. (Bennett, 2008)
- Individuals with limited health literacy reported poorer health status and were less likely to use preventative care. (Nielson-Bohlman, 2004)
- Individuals with low levels of health literacy are more likely to be hospitalized and have bad disease outcomes. (Baker, 2002) and (Schillinger, 2002)
- Inpatient spending increases by approximately $993 for patients with limited health literacy. (Howard, 2004)
- After controlling for relevant covariates, lower health literacy scores were associated with high mortality rates within a Medicare managed care setting. (Baker, 2007)
- The annual cost of low health literacy to the U.S. economy was $106 billion to $238 billion. (Vernon, 2007)
Cancer
- Low literacy adversely impacts cancer incidence, mortality, and quality of life. For example:
- Cancer screening information may be ineffective; as a result, patients may be diagnosed at a later stage.
- Treatment options may not be fully understood; therefore, some patients may not receive treatments that best meet their needs.
- Informed consent documents may be too complex for many patients and consequently, patients may make suboptimal decisions about accepting or rejecting interventions. (Merriman, Betty, CA: A Cancer Journal for Physicians, May/June 2002)
- Among primary care patients with Type 2 diabetes, inadequate health literacy is independently associated with worse glycemic control and higher rates of retinopathy. Inadequate health literacy may contribute to the disproportionate burden of diabetes related problems among disadvantaged populations. (Schillinger, 2002)
Role of the Consumer Health LibrarianMany consumer health initiatives are geared towards technological access to health information or rewriting existing health materials at a simpler language level. Both of these approaches are important, but limited. Easy-to-read materials(link is external) and access to technology are only pieces of a process that must be placed in a larger community context.
This may take the form of providing space for meetings, providing health literacy materials, or actively developing health literacy programs. Consumer health librarians can promote awareness of health literacy among health professionals by creating clearinghouses of health literacy information, sponsoring health literacy seminars, and encouraging multi-organizational collaborations.
The National Action Plan for Health Literacy(link is external) identifies the following strategies for health information and library professionals to contribute to health literacy:
- Help to train all health care staff in the principles of health literacy and plain language.
- Create collections or repositories of materials (e.g. insurance forms and instructions, informed consent and other legal documents, aftercare and medication instruction, and patient education materials) in several languages and review the materials with members of the target population.
- Help to disseminate existing communication tools and resources for patients.
Consumer health librarians can also support the direct needs of health information consumers by providing materials that are multilingual, culturally appropriate and easy-to-read, and by developing methods and materials to teach consumers how to evaluate health information resources, especially those found on the Internet.
ReferencesAgency for Health Care Research and Quality (AHRQ). 2011. Health Literacy Interventions and Outcomes: an Update of the Literacy and Health Outcomes Systematic Review of Literature, 2011
American Medical News. Gerontologists outline how doctors can bridge communication gap with older patients
Bennett IM, Chen J, Soroui JS, et al. The contribution of health literacy to disparities in self-rated health status and preventive health behaviors in older adults.(link is external) Annals of Family Medicine, 2009, May-Jun;7(3):204-11.
Centers for Disease Control and Prevention. Older Adults: Why Is Health Literacy Important?
Davis, T. C., Williams, M. V., Marin, E., Parker, R. M., & Glass, J. (January 01, 2002). Health literacy and cancer communication.(link is external) Ca: a Cancer Journal for Clinicians, 52, 3.)
Howard DH, Sentell T, Gazmararian JA. Impact of health literacy on socioeconomic and racial differences in health in an elderly population.(link is external) Journal of General Internal Medicine, 2006, Aug;21(8):857-61.
Institute of Medicine and Nielsen-Bohlman, L., Panzer, A. M., Kindig, D. A., Health Literacy: A Prescription to End Confusion
Joint Commission. (2007). What did the doctor say?: Improving health literacy to protect patient safety. Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations.
Kutner, M., Greenberg, E., Jin,Y., and Paulsen, C. (2006). The Health Literacy of America's Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006-483).U.S.Department of Education.Washington, DC: National Center for Education Statistics.
Paasche-Orlow, M. K., Riekert, K. A., Bilderback, A., Chanmugam, A., Hill, P., Rand, C. S., Brancati, F. L., Krishnan, J. A. (January 01, 2005). Tailored education may reduce health literacy disparities in asthma self-management.(link is external) American Journal of Respiratory and Critical Care Medicine, 172, 8, 980-6.
Parker R, Ratzan SC. Health Literacy: a second decade of distinction for Americans.(link is external) Journal of Health Communication, 2010:15(Suppl 2)20-33.
Rudd, R. Improving Americans' health literacy.(link is external) New England Journal of Medicine, 2010; 363(24):2283-85.
Schillinger D, Grumbach K, Piette J, et al. Association of Health Literacy With Diabetes Outcomes.(link is external) Journal of the American Medical Association. 2002;288(4):475-482. doi:10.1001/jama.288.4.475.
United States Department of Health and Human Services.Office of Disease Prevention and Health
Promotion. Quick Guide to Health Literacy Fact Sheet: Health Literacy Basics.(link is external)Retrieved December 29, 2016.
Vernon, J. A., Trujillo, A, Rosenbaum, S, (2007). Low health literacy: Implications for national health policy.
Weiss, B. D., American Medical Association., & AMA Foundation. (2007). Health literacy and patient safety: Help patients understand. Chicago, Ill: AMA Foundation.
Williams, M. V., Baker, D. W., Honig, E. G., Lee, T. M., & Nowlan, A. (January 01, 1998). Inadequate literacy is a barrier to asthma knowledge and self-care.(link is external) Chest, 114, 4, 1008-15.
White S, Chen J, Atchison R. Relationship of preventive health practices and health literacy: a national study.(link is external)American Journal of Health Behavior, 2008 May-Jun;32(3):227-42.
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