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Health Literacy: A Public Health Priority


Surgeon General Carmona. Health literacy is the currency of success for everything I am doing as the Surgeon General ... inferences (a general literacy skill) ... – PowerPoint PPT presentation

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Title: Health Literacy: A Public Health Priority

Health Literacy A Public Health Priority
  • Cynthia Baur, Ph.D.
  • Office of Disease Prevention and Health
    Promotion, Office of Public Health and Science,
    U.S. Department of Health and Human Services

HHS Prevention Framework
  • Healthy People 2010 Comprehensive set of disease
    prevention and health promotion objectives for
    the Nation
  • HealthierUS/Steps to a HealthierUS Prevention
    initiative focused on promoting good health and
    preventing chronic disease

Healthy People 2010 Health Communication
  • 11-1 Internet access in the home
  • 11-2 Health literacy
  • 11-3 Research evaluation of health
    communication programs
  • 11-4 Quality of Internet health Web sites
  • 11-5 Centers of Excellence in health
  • 11-6 Provider-patient communication

Health Literacy Objective
  • Improve the health literacy of persons with
    inadequate or marginal literacy skills
  • Healthy People 2010 Objective 11-2

HHS commitment to health literacy and prevention
  • Secretarys Workgroup on Health Literacy as part
    of the Prevention Initiative
  • PreventionA Blueprint for Action
  • Surgeon General Carmona
  • Health literacy is the currency of success for
    everything I am doing as the Surgeon General
  • Speech to AMA House of Delegates, June 2003
  • HHS Health Literacy Workgroup
  • Liaisons and workgroups in most agencies

What is health literacy?
  • 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 2010 Institute of Medicine
    National Library of Medicine

Scope of health literacy
  • Functional skills
  • Knowledge of particular health topics
    (information services)
  • Knowledge must be related to decision making

Health literacy research documents
  • Health literacy A prescription to end confusion
  • IOM Report 2004
  • Literacy and health outcomes
  • AHRQ Evidence Report 2004
  • Understanding health literacy and its barriers
  • NLM Current Bibliography 2004

Other HHS resources
  • Health Literacy and Provider/Patient
    Communication Action Plans
  • Develop national focus and agenda
  • Assess and alter professional practices
  • Invest in training and research
  • Enhance access and utility of health information
  • Identify metrics for improved communication
  • Partner with organizations working to improve
    literacy across the lifespan

HHS activities
  • Department-wide and agency workgroups
  • NIH/AHRQ Health Literacy Program Announcement
  • Program assessments
  • Benchmarks
  • Plain language assessments
  • Provider training
  • Measurement of HP2010 Objective

Health literacy assessment
  • 1992 National Adult Literacy Survey (NALS) no
    focus on health tasks
  • 2003 National Assessment of Adult Literacy
    Health Literacy Component
  • U.S. Department of Education http//

2003 National Assessment of Adult Literacy
  • Nationally representative assessment of the
    English language literacy skills of Americans age
    16 and older
  • Household survey of approximately 20,000
  • Data on background characteristics, performance
    of everyday literacy tasks and skills underlying

General skills assessed by health literacy tasks
  • Word-level reading skills Decoding and
    recognizing words
  • Language comprehension skills Understanding the
    structure and meaning of sentences
  • Text search skills Searching text efficiently
  • Inferential skills Drawing appropriate
    text-based inferences
  • Computation identification skills Identifying
    the calculations required to solve quantitative
  • Computation performance skills Performing any
    required calculations
  • Application skills Using newly searched,
    inferred, or computed information to accomplish a
    variety of goals
  • Slides on HLC from S. White, August 2004

NAAL Health Literacy Component
  • Objective data based on respondents performance
    on health-related tasks from everyday life
  • Measures ability to understand and use
    health-related print information
  • Aspects NOT covered
  • Oral communication
  • Knowledge
  • Jargon and technical terms

Bringing to bear general literacy skills on
health tasks
  • The health literacy score measures the ability to
    apply general literacy skills to perform a
    variety of health-related tasks
  • For example, one must
  • Search text effectively and efficiently (a
    general literacy skill) to complete a patient
    information form (a health-related task)
  • Draw appropriate inferences (a general literacy
    skill) to follow health screening recommendations
    (a health-related task)
  • Perform appropriate computations (a literacy
    skill) to avoid under- or over-dosing (a
    health-related task)

Uses of health literacy data
  • HLC data can assist in
  • Identifying the health literacy skills of target
  • Guiding the development of health information
    tailored to the literacy strengths and weaknesses
    of target audiences so that the written material
    is less likely to exceed the literacy skills of
    target audiences
  • Providing input for development of programs to
    improve health literacy skills

Goal increased health literacy in the service of
better decisions and health
  • Credible, understandable and applicable
    information for all
  • Systems that help and support rather than hinder,
    frustrate or embarrass
  • Providers who are informed about what they need
    to communicate to all patients and clients
  • Providers who communicate clearly and
    appropriately with all patients and clients