Health Literacy Intro KY

8/14/2019 Health Literacy Intro KY

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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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An Apple a day

keeps the doctor

away.

Time heals all wounds.


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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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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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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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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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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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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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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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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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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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Health OutcomesHealth Outcomes


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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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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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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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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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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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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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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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Literacy in KentuckyLiteracy in Kentucky

2003 NAAL2003 NAAL

-2003 NAAL


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2003 NAAL2003 NAAL

-2003 NAAL


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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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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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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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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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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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What next??What next??


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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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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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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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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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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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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 !

Documents

Health Literacy Intro KY