Clinical Governance Unit

2013

What is Health Literacy?

Outline

1. What is health literacy?

2. How does health literacy affect health?

3. Who is at greater risk?

4. What can we do about it?

5. How we got started ?

What is Health Literacy?

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.” (Institute of Medicine 2004)

2. Communicative / interactive literacy –Consumer obtains relevant information, derives meaning and applies new information to changing circumstances

3. Critical health literacy – most advanced consumer who can critically analyse information to respond, adapt and control life events and situations

(Nutbeam 2000, Freebody &Luke 1990),

1.Functional health literacy Consumer has ability to apply basic literacy and numeracy skills to access and act upon health information.

Levels of health literacy

How health literate is the Australian consumer?

59% of Australians aged 15 to 74 years do not have the health literacy skills needed to understand everyday health information to effectively access and use health services.

(Adult Literacy and Life Skills Survey (ALLS), ABS 2006)

How health literate is the Australian consumer?

Most people’s health literacy is at the reading age of a year 6-8 level

People with low health literacy are between 1.5 and 3 times more likely to experience a poor health outcome. (ACSQHC, 2013)

Addressing health literacy in a coordinated way has the potential to increase safety and quality of care.

(ACQSHC 2013, Institute of Medicine 2013, DeWalt 2004)

How does literacy affect

health?

People with low health literacy have: Poorer self-care and chronic disease management skills

Lower levels of knowledge about disease and poorer response to information seeking

Increased feelings of discomfort / shame associated with difficulties in understanding

Lower take up of health promoting behaviours, such as exercising and eating a healthy diet

Less success in navigating the healthcare system, including locating providers and services and filling out forms

People with low health literacy have: Higher rates of chronic illness (e.g. hypertension,

heart disease, diabetes, obesity)

Higher rates of mortality (any cause)

Higher hospitalisation rates and use of emergency services

Lower rates of preventive services such as screening

Greater medication errors (Dewalt et al, 2004)

The cost of poor health literacy

Health literacy affects health behaviours, as well as quality and safety of care, health outcomes and healthcare costs.

In Australia: 2 to 3% of hospital admissions are adverse drug events

(140, 000pa) and costs $350 million pa In America: In 2001, low functional literacy resulted in an estimated

$32 to $48 billion in additional healthcare costs.

Who is at greater risk?

Poorer health literacy is greater amongst:

The aged

Those from low socio-economic backgrounds

People with limited education

Aboriginal and Torres Strait Islanders

CALD persons with poor English proficiency

Who is at greater risk?

What can we do about it?

Ten attributes of Health Literate Health Care Organisations

According to (Brach et at 2012) Institute of Medicine, Washington DC, a health literate organisation:

Has Leadership makes literacy integral to its operations

Integrates Health literacy into plans, measures evaluation and patient safety and Quality improvements

Prepares and skills workforce in becoming a health literate organisation

Ensures easy access in navigating systems and information

Communicates effectively

Explains coverage and costs

Targets high risk situations

Involve consumers

Meets all needs

Designs easy to use materials

How do we get started ?

How did we get started? We developed:

a health literacy framework

an ISLHD Procedure for the Development and Approval of Patient Information In Plain English

a one stop patient information portal (PIP) for staff to produce with consumers plain English Resources

A Health Literacy Ambassador Program

What we get started? We have incorporated health literacy in our: corporate orientation multilingual grants program ACCESSAbility program- partnering with

consumers to improve access and navigation in our hospitals

C=communication with consumers through “Teach Back”

We produced patient information in Plain English –BEFORE

Black on white or white on black is best

Keep your sentences short and use simple words.

Large bold font is useful for highlighting and emphasising text – italics and underlining can make text more difficult to read.

Make information accessible for people with limited English

Use ‘you’ and ‘we’

Use diagrams and pictures to enhance text

Use direct instructions

Lowercase letters are easier to read; use at least 12 point font

Bulleted or numbered points help to break

down the information

and after….

The Policy Perspective

Health Literacy is addressed at a National Level. It is incorporated into National Framework for Quality and Safety and the

Australian Commission on Safety and Quality in Health Care has recommended that by 2017:

- health care organisations are health literate

- consumers and health care providers understand each other