health literacy: tools you can use julie gazmararian, phd, mph kara jacobson, mph, ches department...
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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
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