Health Literacy:Tools You Can Use

Health Literacy:Tools You Can Use

Julie Gazmararian, PhD, MPH

Kara Jacobson, MPH, CHES

Department of Health Policy and ManagementRollins School of Public Health

Emory University

Julie Gazmararian, PhD, MPH

Kara Jacobson, MPH, CHES

Department of Health Policy and ManagementRollins School of Public Health

Emory University

Overview

Overview of health literacy• Definition• Prevalence• Impact

Strategies for improved communication• Tools• Assessment

Open discussion

National Adult Literacy Survey (NALS)

“Using printed and written information to function in society, to achieve one’s goals, and to develop one’s knowledge and potential” (National Literacy Act of 1991)

Prose, Document, Quantitative

NALS 2003 ResultsNALS 2003 Results

14%

22%

29%

33%

44%

33%

13%

13%

Prose

Quantitative

Below Basic Intermediate Proficient

14%

22%

29%

33%

44%

33%

13%

13%

Prose

Quantitative

Below Basic Intermediate Proficient

National Adult Literacy Study, 2003National Adult Literacy Study, 2003

Health Literacy

Healthy People 2010 Objective 11-2: Improve health literacy Objective 17-3: Increase review with older patients newly prescribed and

OTC medications

AHRQ Evidenced-based review of health literacy

IOM Priority Areas for National Action: Self-management/Health literacy Report from Committee on Health Literacy

What is Health Literacy?

In this report, the committee accepted the definition of health literacy presented by the National Library of Medicine:

(Selden et al. 2000; Healthy People 2010, HHS 2000; Ratzan & Parker 2000)

The degree to which individuals have the capacity to

obtain, process, and understand basic health

information and services needed to make appropriate

health decisions

What is Health Literacy?

Not only reading skill….BUT ALSO Writing Speaking Listening Numeracy Cultural and Conceptual knowledge

"The health of our country depends on our understanding of basic health information in order to lead a healthy life"

U.S. Surgeon General Carmona

39

Low “health” literacy

1 out of 3

Low literacy

1 out of 4

Health Literacy Challenges

Most people cannot understand health information they

need

It’s hard to be a patient these days and it’s easy to mess

up

An issue of quality — essential for self-management,

reducing disparities and reducing costs

Problems Associated with Low Health Literacy

Compliance with medication

Poor health status

Knowledge of basic self-care

Hospitalizations

Follow-up visits Physician visits

Comprehension of informed consent, medical forms, insurance benefits

Costs

Health Outcomes Associated with Literacy

General health status Hospitalization Emergency department use Prostate cancer stage Depression Diabetes control HIV control Mammography Pap smear Pneumococcal immunization Influenza immunization STD screening

Behavioral Outcomes Associated with Literacy

Substance abuse Breastfeeding Behavioral problems Adherence to medication Smoking

Knowledge-related Outcomes Associated with Literacy

Birth control knowledge Cervical cancer screening Emergency department instructions Asthma knowledge Hypertension knowledge

Does Inadequate Literacy Lead to Excess Medicare Hospital Costs?Does Inadequate Literacy Lead to Excess Medicare Hospital Costs?

36 Million Medicare Eligible36 Million Medicare Eligible

44% Functionally Illiterate(16 million)

44% Functionally Illiterate(16 million)

$ 2,262 per Person / Year$ 2,262 per Person / Year

25% - 50% Higher Hospital Costs25% - 50% Higher Hospital Costs

Excess Hospital Costs = $8 - $15 BILLIONExcess Hospital Costs = $8 - $15 BILLION

The main problem with communication is the assumption

that it has occurred.

George Bernard Shaw

The main problem with communication is the assumption

that it has occurred.

George Bernard Shaw