Healthy Literacy Missouri

Wisconsin Health Literacy Summit April 1, 2009

Madison, WisconsinArthur Culbert, Ph.D.

Senior Advisor to the Missouri Foundation for Health

Interim Executive DirectorHealth literacy Missouri

Wisconsin State Capitol Collapses

April Fools

In 1933 The Madison Capital-Times ran a picture on its front page showing the dome of the Wisconsin State Capitol collapsing. A headline announced, "Dome Topples Off Statehouse," while the subhead read, "Officials Say Legislature Generated Too much Hot Air."

Retirement

Today’s talk

• Nation wide efforts in health literacy

• Health Literacy Missouri (HLM)

• HLM Resource Inventory

Health Literacy

• Complex social determinant of health

• Public health issue

• Costs Dollars but Really cost lives

90 Million adults in America have trouble reading this drug label

Health Care Reform

National Agenda for Health Literacy

• Healthy People 2000• IOM Health Literacy Report, 2004• Surgeon General Workshop, 2006• HHS National Town Hall Meetings, 2007,08• Health Literacy Missouri, 2009• A Call to Action to Improve Health Literacy• Health Literacy Coalition

Mid West State Wide Health Literacy Initiatives

Minnesota Health Literacy Partnership

Iowa Center for Health Literacy

Wisconsin Literacy Inc.

Health Literacy Missouri

Health Literacy Missouri (HLM)

• MFH determined health literacy components in previous proposals (2002-2005)

• Awarded $2.1 million in 2007 as part of 5 years funding

• Open a Missouri wide health literacy center in 2009

HLM Partners

HLMVision and Mission

• Our mission is to improve the health of all Missourians and our vision is to become a national leader in health literacy.

• Develop health information– Accurate– Understandable– Accessible– Available to all

• Create systematic change in provider patient encounter based on health literacy

• DOES NOT BLAME VICTIM

HLMPhilosophy

HLMGuiding Principles

• Engage Community Partners

• Put Missourians First

• Innovate Strategically

ACP ‘Living with Diabetes’ Guide

• Guide Developed in 2006

• ‘Need-to-Know’ content only

• Photos and action plans

• Testimonials and examples

• Over 1 million copies distributed

•300,000 living with diabetes in Missouri

Cost of Low Health Literacy in Missouri

Hot spots of low literacy

MFH/HLM Activities

Field testing American College of Physicians Living with Diabetes Guide (ACP 2007 - )

Cosponsored with CDC town hall meeting on health literacy (May 2008)

Determined Economic cost (Vernon, 2008)Located ‘hot spots’ of low literacy using GIS

Mapping (lurie, 2009)Demonstration projects (2008 - )

Demonstration Projects

Engage the community in creative ways to advance health literacy

Demonstration Projects

Strategic Communications Local graphics are created for each region. Research has shown that including graphics with the release increase the chance of having it used.

Health Literacy Curriculum

• Target Population: ALL health professions students, and providers

• Continuum:– Health literacy training through Missouri AHEC

pre- health professional students– Raise awareness and provide best practices for

health professional students and providers

Health Literacy Surveillance

Attempt to survey & measure health literacy

– Missourians

– Health care providers

– Create baseline of health literacy levels

HLM Resource Inventory

• Identified 4,000+ health literacy resources

• Inventorying health literacy resources:• Easily accessible • Well organized• User friendly• HLM Rating• Meet User’s needs

To evaluate a resource…

1. Obtain the resource

2. Identify resources in the Resource Inventory database

3. Evaluate the resource on 3 dimensions:– Soundness of Approach– Easy to Use– Evidence-based

86-100%

50-85%

≤ 49%

HLM Rating

[insert photo of clinic manager]

What is the solution?

THE HEALTH LITERACY PROBLEM:

Diabetes patients don’t return for follow-up appointments

The doctors use words the patients don’t understand and the patients won’t ask them to explain because they think they ought to know or they have tried in the past and the doctor sometimes can’t explain it in understandable terms.

Doctors have a hard time bringing it down to an average person’s level of understanding.

““

PROFESSIONALS

•Create easy-to-use materials

•Find information on health topics

•Develop a policy

•Develop a program

•Teach others about health literacy

•Help patients access the health system

•Learn about cultural issues

•Get the facts about health literacy

•Get the facts about literacy

•Search the latest research

GENERAL PUBLIC

•Learn about a health topic

•Get information about insurance

•Protect my child’s health

•Take my medication

•Talk to my doctor

•Make treatment decisions

•Know my health risks

•Get the facts about reading ability

•Get the facts about health literacy

•Read about culture and health

•Find materials in other languages

HEALTHCARE PROVIDERS

•Get the facts about health literacy

•Find easy-to-use materials for patients

•Learn how to speak with my patients

•Learn about cultural issues

•Help patients access the health system

•Teach others about health literacy

•Get the facts about literacy

•Assess health literacy levels

•Assess literacy levels

•Search the latest research

PROFESSIONALS

•Create easy-to-use materials

•Find information on health topics

•Develop a policy

•Develop a program

•Teach others about health literacy

•Help patients access the health system

•Learn about cultural issues

•Get the facts about health literacy

•Get the facts about literacy

•Search the latest research

GENERAL PUBLIC

•Learn about a health topic

•Get information about insurance

•Protect my child’s health

•Take my medication

•Talk to my doctor

•Make treatment decisions

•Know my health risks

•Get the facts about reading ability

•Get the facts about health literacy

•Read about culture and health

•Find materials in other languages

HEALTHCARE PROVIDERS

•Get the facts about health literacy

•Find easy-to-use materials for patients

•Learn how to speak with my patients

•Learn about cultural issues

•Help patients access the health system

•Teach others about health literacy

•Get the facts about literacy

•Assess health literacy levels

•Assess literacy levels

•Search the latest research

Learn about our scoring system

• Insert info for AMA manual here. Will look similar to slide #12

• S of A = yellow• E of U = green• Ev-b = green

Next Steps for HLM

• Continue to develop and refine HLM’s niche in field of health literacy

• Form more partnerships and develop coalition

• Assist in the Call to Action for Health Literacy

I am hopeful that when we ask the question, “Can we overcome the health literacy issues of our great nation?” The answer is a resounding

Yes We Can!!