health literacy intro ky
TRANSCRIPT
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Is More actually Less??Is More actually Less??
By partaking of the fleshy, usuallyBy partaking of the fleshy, usuallyrounded, edible pomme fruit off a tree ofrounded, edible pomme fruit off a tree ofthe rose family, one might potentiallythe rose family, one might potentially
maintain a distant relationship with onesmaintain a distant relationship with onesprimary healthcare practitioner.primary healthcare practitioner.
The indefinite and continuous durationThe indefinite and continuous durationregarded as that in which events succeedregarded as that in which events succeed
one another acts to set right divisions ofone another acts to set right divisions oftissue or ruptures of the integument ortissue or ruptures of the integument ormucous membrane, due to externalmucous membrane, due to externalviolence or some mechanical agencyviolence or some mechanical agencyrather than disease.rather than disease.
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
An Apple a day
keeps the doctor
away.
Time heals all wounds.
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
American Medical AssociationAmerican Medical Association
FoundationFoundation
Health Literacy ToolkitHealth Literacy Toolkit
http://www.ama-assn.org/ama/pub/cathttp://www.ama-assn.org/ama/pub/cat
http://www.ama-assn.org/ama/pub/category/8115.htmlhttp://www.ama-assn.org/ama/pub/category/8115.htmlhttp://www.ama-assn.org/ama/pub/category/8115.html -
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
What is health literacy?What is health literacy?
Health literacy is the ability of individualsHealth literacy is the ability of individualsto read, understand, and act upon health-to read, understand, and act upon health-
related information.related information. Health literacy also refers to the capacityHealth literacy also refers to the capacity
of professionals and institutions toof professionals and institutions to
communicate effectively so thatcommunicate effectively so that
community members can make informedcommunity members can make informeddecisions and take appropriate actions todecisions and take appropriate actions to
protect and promote their health. (NYCprotect and promote their health. (NYCMayors Office of Adult Education)Mayors Office of Adult Education)
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
What is health literacy?What is health literacy?
The ability to understand and useThe ability to understand and use
health-related printed information inhealth-related printed information in
daily activities at home, at work, anddaily activities at home, at work, andin the community to achieve one'sin the community to achieve one's
goals and to develop one'sgoals and to develop one's
knowledge and potential.knowledge and potential.NAAL, 2003NAAL, 2003
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
What is health literacy?What is health literacy?
Health literacy is the capacity toHealth literacy is the capacity to
obtain, process and understand basicobtain, process and understand basic
health information and serviceshealth information and servicesneeded to make appropriate healthneeded to make appropriate health
decisions.decisions. (US Department of Health and Human Services,(US Department of Health and Human Services, www.health.gov/
communication)
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
What is health literacy?What is health literacy?
The ability to read and comprehendThe ability to read and comprehend
basic concepts and tasks needed tobasic concepts and tasks needed to
function sufficiently in the healthfunction sufficiently in the healthcare systemcare system
-U.S. Department of Adult-U.S. Department of Adult
Education, Fact Sheet 20Education, Fact Sheet 20
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Types of literacyTypes of literacyCan Isearch, comprehendand use information
found in these types of documents or forms???
Prose LiteracyProse Literacy
The knowledge and skills needed toperform tasks related to writing.
Examples: writing such as
newspaper articles, editorials,brochures ad instructional materials.
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Types of literacyTypes of literacyCan Isearch, comprehendand use information
found in these types of documents or forms???
Document LiteracyDocument Literacy
The knowledge and skills needed to
perform related to forms and shortprose passages.
Examples: job applications, payroll
forms, bus schedules, maps, anddrug and food labels.
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Types of literacyTypes of literacyCan Isearch, comprehendand use information
found in these types of documents or forms???
Quantitative LiteracyQuantitative Literacy
The knowledge and skills required toperform tasks related to numbersand numeracy.
Examples: balancing a checkbook,figuring out a tip, or determiningamount of interest on a loan.
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Why Health Literacy?Why Health Literacy?
Low health literacy can have anLow health literacy can have an
impact on anyone - regardless ofimpact on anyone - regardless of
age, race, education or income level.age, race, education or income level. Patients/Clients who have difficultyPatients/Clients who have difficulty
understanding health information areunderstanding health information are
at a higher risk for poor healthat a higher risk for poor healthoutcomes.outcomes.
- Pfzierhealthliteracy.com- Pfzierhealthliteracy.com
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Health OutcomesHealth Outcomes
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Individuals with low healthIndividuals with low healthliteracy skills are much moreliteracy skills are much more
likely to:likely to:
Engage the healthcare systemEngage the healthcare system
throughthrough preventablepreventable hospital visitshospital visitsand admissionsand admissions
Stays are 2 days longerStays are 2 days longer
Studies have demonstrated a higher rate ofStudies have demonstrated a higher rate of
hospitalization and use of emergencyhospitalization and use of emergencyservicesservices
This higher use is associated with higherThis higher use is associated with higherhealthcare costs.healthcare costs. Some estimates have been as high as $73Some estimates have been as high as $73
Kirsch, Jugebut, Jenkins, &Kolstad. 1993
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
More on the financial impact.More on the financial impact.
A 2-year outcome study (by TheA 2-year outcome study (by The
Kaiser Foundation) found that theKaiser Foundation) found that the
use of a self-help handbook for thoseuse of a self-help handbook for thosewith lower health literacy resulted inwith lower health literacy resulted in
a:a:
12.2% reduction in primary care visits12.2% reduction in primary care visits 17.1% reduction in urgent care visits17.1% reduction in urgent care visits
15.4% reduction in emergency room visits15.4% reduction in emergency room visits
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Individuals with low healthIndividuals with low health
literacy skills and Diabetes:literacy skills and Diabetes:
Were less likely to have effective glycemicWere less likely to have effective glycemic
controlcontrol Were more likely to report vision problemsWere more likely to report vision problems
caused by their diabetescaused by their diabetes
Schillinger, Grumbach,
Piette, et al. 2002
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Individuals with low healthIndividuals with low healthliteracy skills are much moreliteracy skills are much more
likely to:likely to:
To report their health as poor orTo report their health as poor or
not be knowledgeable enough to givenot be knowledgeable enough to givean accurate estimate of their ownan accurate estimate of their own
health (Kentucky)health (Kentucky)
Report a sense of shame about theirReport a sense of shame about theirskill level.skill level. As a result, they may hide reading orAs a result, they may hide reading or
vocabulary difficulties to maintain theirvocabulary difficulties to maintain their
dignitydignity
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Who is at risk?Who is at risk?
Those who live in poverty.These individuals are more likely to:
be exposed to environmental andoccupational hazards which impact health
have limited or substandard educational,housing, and employment opportunities
which affect health and/or have limited access to health promotion,
disease prevention, and curative programswhich ensure health.
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Health Literacy in the USHealth Literacy in the US
NAAL 2003NAAL 2003 Older adults (65+)Older adults (65+)
40% Intermediate or40% Intermediate orProficientProficient
60% Basic or Below60% Basic or BelowBasicBasic
Education LevelEducation Level
77% of those with some77% of those with somehigh school or less thanhigh school or less thana high school educationa high school educationhad Basic or Belowhad Basic or BelowBasic health literacy.Basic health literacy.
NCES, 2003
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Health Literacy in the USHealth Literacy in the US
NAAL 2003NAAL 2003 Adults with employer based healthAdults with employer based health
insurance had the HIGHEST healthinsurance had the HIGHEST health
literacy rates.literacy rates. Adults receiving Medicare, MedicaidAdults receiving Medicare, Medicaid
or those who had no health insuranceor those who had no health insurance
had lower health literacy than thosehad lower health literacy than thosecovered by other health insurance.covered by other health insurance.
NCES, 2003
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Literacy in KentuckyLiteracy in Kentucky
2003 NAAL2003 NAAL
-2003 NAAL
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Literacy in KentuckyLiteracy in Kentucky
2003 NAAL2003 NAAL
-2003 NAAL
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Literacy in KentuckyLiteracy in Kentucky
2003 NAAL2003 NAAL Similar to the US as a nation,Similar to the US as a nation,
average literacy of Black Americansaverage literacy of Black Americans
was lower than the average literacywas lower than the average literacyof White Americans (in all types ofof White Americans (in all types of
literacy)literacy)
-2003 NAAL
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Implications for theImplications for the
CommonwealthCommonwealth Special attention to health andSpecial attention to health and
literacy of minority individualsliteracy of minority individuals Age (those over 65)Age (those over 65) Race (Black individuals and non-EnglishRace (Black individuals and non-English
speakers)speakers)
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Can we generalize for theCan we generalize for the
entire state?entire state? Due to the fact that there are higher levelsDue to the fact that there are higher levels
of unemployment in Appalachian countiesof unemployment in Appalachian countiesas compared to the rest of the counties inas compared to the rest of the counties in
the statethe state (U.S. Census, 2000).(U.S. Census, 2000). Due to the fact that there are higher levelsDue to the fact that there are higher levels
of poverty in Appalachian counties asof poverty in Appalachian counties ascompared to the rest of the counties in thecompared to the rest of the counties in thestatestate (U.S. Census, 2000).(U.S. Census, 2000).
Due to the fact that, in 1992, there wereDue to the fact that, in 1992, there werelower rates of literacy in Appalachianlower rates of literacy in Appalachiancounties as compared to the rest of thecounties as compared to the rest of thecounties in the statecounties in the state (Kentucky Department of(Kentucky Department of
Education, 1997)Education, 1997)..
NO
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Figure 16: Kentucky Average Prose, Document, and
Quantitative Proficiencies by Poverty Status
Kentucky Adult Literacy Survey, 1995
304298 295
248 253 244
0
100
200
300
400
500
P ro s e D o c u m e n t Q u a n tita tiv e
AverageProficien
cies
Not Poo r Poo r \ Near Poo r*
*As Defined by U.S. Census Bureau
- 56 points - 45 points - 51 points
Figure 2: Average Kentucky Prose, Document,
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
303 294 285264
282
0
100
200
300
400
500
B lu eg ras s L ouis vi lle No rt he rn E as te rn W es te rn
AverageProficiencies
Prose
299 291 283265
281
0
100
200
300
400
500
B lu eg ras s L ouis vi lle No rt he rn E as te rn W es te rn
Average
Proficiencie
s
Document
291 284 279264
278
0
100
200
300
400
500
B lu eg ras s L oui sville No rt he rn E as ter n W es te rn
Average
Proficiencies
Quantitative
g g y , ,
and Quantitative Proficiency by Region
Kentucky Adult Literacy Survey, 1995
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
What next??What next??
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Things you can doThings you can do
Educate yourself !!!Educate yourself !!!Test your written materials forTest your written materials for
readabilityreadabilityTake a class on healthTake a class on health
communicationcommunication Find and use web resourcesFind and use web resources
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
GREAT Resources !!!GREAT Resources !!!
Most are FREE!!!Most are FREE!!!
http://images.google.com/imgres?imgurl=http://www.clearlanguagegroup.com/images/portfolio_images/develowlevel.jpg&imgrefurl=http://www.clearlanguagegroup.com/portfolio/p_lowliterate.html&h=400&w=301&sz=16&hl=en&start=1&um=1&tbnid=bojBsEfXft2VMM:&tbnh=124&tbnw=93&prev=/images%3Fq%3D%2522Clear%2Band%2BSimple%2522,%2BNCI%26um%3D1%26hl%3Denhttp://images.google.com/imgres?imgurl=http://www.clearlanguagegroup.com/images/portfolio_images/develowlevel.jpg&imgrefurl=http://www.clearlanguagegroup.com/portfolio/p_lowliterate.html&h=400&w=301&sz=16&hl=en&start=1&um=1&tbnid=bojBsEfXft2VMM:&tbnh=124&tbnw=93&prev=/images%3Fq%3D%2522Clear%2Band%2BSimple%2522,%2BNCI%26um%3D1%26hl%3Denhttp://images.google.com/imgres?imgurl=http://www.clearlanguagegroup.com/images/portfolio_images/develowlevel.jpg&imgrefurl=http://www.clearlanguagegroup.com/portfolio/p_lowliterate.html&h=400&w=301&sz=16&hl=en&start=1&um=1&tbnid=bojBsEfXft2VMM:&tbnh=124&tbnw=93&prev=/images%3Fq%3D%2522Clear%2Band%2BSimple%2522,%2BNCI%26um%3D1%26hl%3Den -
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Assessing Written MaterialsAssessing Written Materials ResourcesResources
AMA Foundation ToolkitAMA Foundation ToolkitAccessible online at http://www.ama-Accessible online at http://www.ama-
assn.org/ama/pub/category/9913.htmlassn.org/ama/pub/category/9913.html
CDC - Simply Put
F
REE
F
REEF
EE
$35
NCI-The Pink Book
Making Health
Communication Programs
Work
NCI-Clear and Simple
http://images.google.com/imgres?imgurl=http://www.clearlanguagegroup.com/images/portfolio_images/develowlevel.jpg&imgrefurl=http://www.clearlanguagegroup.com/portfolio/p_lowliterate.html&h=400&w=301&sz=16&hl=en&start=1&um=1&tbnid=bojBsEfXft2VMM:&tbnh=124&tbnw=93&prev=/images%3Fq%3D%2522Clear%2Band%2BSimple%2522,%2BNCI%26um%3D1%26hl%3Denhttp://images.google.com/imgres?imgurl=http://www.clearlanguagegroup.com/images/portfolio_images/develowlevel.jpg&imgrefurl=http://www.clearlanguagegroup.com/portfolio/p_lowliterate.html&h=400&w=301&sz=16&hl=en&start=1&um=1&tbnid=bojBsEfXft2VMM:&tbnh=124&tbnw=93&prev=/images%3Fq%3D%2522Clear%2Band%2BSimple%2522,%2BNCI%26um%3D1%26hl%3Den -
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
Beyond the BrochureBeyond the Brochure
http://www.cdc.gov/dhdsp/CDCynergy_thttp://www.cdc.gov/dhdsp/CDCynergy_t
FRE
E
ommun ca ng ea : r or esd St t i f Pd St t i f P
http://www.cdc.gov/dhdsp/CDCynergy_training/Content/activeinformation/resources/Beyond_the_Brochure.pdfhttp://www.cdc.gov/dhdsp/CDCynergy_training/Content/activeinformation/resources/Beyond_the_Brochure.pdfhttp://www.cdc.gov/dhdsp/CDCynergy_training/Content/activeinformation/resources/Beyond_the_Brochure.pdf -
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
gand Strategies for Progressand Strategies for Progress
Action Plans To Achieve the HealthAction Plans To Achieve the Health
CommunicationCommunication
Objectives in Healthy People 2010Objectives in Healthy People 2010
http://odphp.osophttp://odphp.osophs.dhhs.gov/projehs.dhhs.gov/proje
cts/HealthComm/cts/HealthComm/
F
REE
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Ann Rathbun, Ph.D.Ann Rathbun, Ph.D.
FREE SMOG calculatorFREE SMOG calculator
http://www.harrymclaughlin.com/SMOG.http://www.harrymclaughlin.com/SMOG.
FREE
http://www.harrymclaughlin.com/SMOG.htmhttp://www.harrymclaughlin.com/SMOG.htmhttp://www.harrymclaughlin.com/SMOG.htm -
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Do weDo we have tohave to serve the individualsserve the individuals
who dont read well and,who dont read well and,
consequently, are not the mostconsequently, are not the mosteducated consumers?educated consumers?
NO !NO !
But its theBut its the RIGHT THINGRIGHT THING to do !to do !