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Role of Community Organizations Role of Community Organizations to Improve Health Literacyto Improve Health Literacy

Linda Neuhauser, DrPH Linda Neuhauser, DrPH St. Louis UniveristySt. Louis Univeristy

St. Louis, MOSt. Louis, MOOctober 15, 2010October 15, 2010

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Today’s Discussion

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Health LiteracyHealth Literacy

“The degree to which individuals have the capacity to obtain, process, understand, and act on basic health information and services needed to make appropriate health decisions.”

It includes: Reading, listening, speaking, using numbers, motivation, and action

Health Literacy is Empowerment

It’s about using information to take control

and create a healthy life

Why is Health Literacy a Problem?

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Health Literacy Skills are Low in the US

U.S. high school dropout rate is U.S. high school dropout rate is 30%30%

The Demands of the Health System Are Too High for Most People:

• Learning about prevention

• Understanding advice from the media

• Using health care

• Dealing with insurance

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National Assessment of Adult Literacy, 2003

Below Basic: No more than the most simple & concrete literacs

Basic: Can perform simple everyday literacy activities

Intermediate: Can perform moderately challenging literacy activities

Proficient: Can perform complex and challenging literacy

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How well do patients understand how to take their medicine or prepare for a medical procedure?

The US health system only works for

12% of Americans

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What is it like?

GNINAELC – Ot erussa hgih ecnamrofrep, yllacidoirep naelc eht epat sdaeh dna natspac revenehw uoy eciton na noitalumucca fo tsud dna nworb-red edixo selcitrap. Esu a nottoc baws denetsiom htiw lyporposi lohocla. Eb erus on lohocla sehcuot eht rebbur strap, sa ti sdnet ot yrd dna yllautneve kcarc eht rebbur. Esu a pmad tholc ro egnops ot naelc eht tenibac. A dlim paos, ekil gnihsawhsid tnegreted, lliw pleh evomer esaerg ro lio.

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A Patient’s Story

(AMA video)

• The average American reads at the 8th grade level--3 to 4 grades below last grade completed.

• 20% read below the 5th grade level

• Most health information is written at the 10-12th grade level.

US Reading Levels Compared toHealth Information Readability

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Mismatched Communication

Information is Information is too complicated too complicated for for people’s health literacy abilitiespeople’s health literacy abilities

After a Clinical Encounter, Patients may…

Forget or misunderstand 50% of what the physician said

Up to ½ of US population may be at risk for…

– Medical misunderstandings

– Mistakes taking medications, etc. (2/3)

– Excess hospitalizations (2X)

– Poor health outcomes (1.5-3X)

– Unnecessary deaths

Estimated annual costs of low health literacy to the economy

U.S. $106 to $238 billion

Vernon J. et al, 2007

Health Literacy Is…

A better predictor of health status than

income, race/ethnicity, age, education level

or employment

Person

Family

Hospitals Pharmacy

CBO

Community

School

Adult Literacy

Library

Media New Media

Congress

Government

HealthCare

Policy

Socio-Ecological Model

How to improve health literacy in the health care system

1. Create a shame-free environment

2. Conduct “patient-centered” appointments

3. Improve interpersonal communication with patients: “teach back”

4. Create and use patient-friendly materials

Module 1

Use “Teach Back”

Ask patient to demonstrate understanding: “What will you tell your spouse about your

condition?” “I want to be sure I explained everything clearly, so

can you please explain it back to me so I can be sure I did?”

Avoid asking: “Do you understand?”

Community Projects to Improve Health Literacy

Health Literacy Missouri

Fathers’ Support Center’s Family Formation Program

Group discussion about lessons learned from the Straight Talk with Your Doc Workshop

Standardized Patient Encounter-University of Missouri

Project Know at The Kitchen Clinic