HLTH 210 Lecture Notes - Lecture 12: Natural-Born-Citizen Clause, Ministry Of Statistics And Programme Implementation, Managed Care

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Health literacy: a hidden epidemic
Purpose
To increase familiarity of the evidence of health literacy and its impact on health
Emphasis placed on the state of the research on health literacy, identifying what
we know, and what gaps exist
Functional literacy - an individuals ability to read, write, and speak in english, and
compute and solve problems at levels of proficiency necessary to function on the job and
in society, to achieve one’s goals and develop one’s knowledge and potential
Literacy in america: National Assessment of Adult Literacy (NAAL)
National sample survey conducted in 2003 and 1992
Performed by US department of education, national center for health statistics
In person interviews with americans age 16 and older
Tested in english or spanish
Over sampling of blacks and hispanics
NAAL domains and scoring
Emphasized the use of printed everyday materials (newspapers, prescriptions,
bills) needed to function adequately in one’s environment
153 items that assessed prose, document or quantitative literacy
Most items required searching text for specific information, short written
responses
Scores on the NAAL
Proficient: complex and challenging literacy activities
Intermediate: moderately complex literacy activities
Basic: simple every day activities
Below basic: no more than the most simple and concrete literacy skills
2003 national assessment of adult literacy
93 million adults have basic or below basic literacy (43%)
52% of high school grads
61% of adults > 65
Literacy and race/ethnicity
Hispanic and blacks are the most illiterate
Low literacy rates by county, 2000
Nearly ¼ of GA adults may be illiterate
Education DOES NOT EQUAL literacy
Grade level completion does not correlate to actual reading level: adults with
10th grade education read at a 7th - 8th grade level
Mothers have reading levels four to five grades lower than their actual school
grade completion
Medicaid recipients have a mean reading equivalency level of 5th grade
Individual’s ability to read is more accurate and indicates ability to acquire new
knowledge
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
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Builds on literacy skills bUT ALSO
Cultural consideration
Topic area and conceptual knowledge across a wide range, for example
Knowledge of bodily functions
Terms for specific health conditions
Understanding of how scientific discovery works
Writing
Speaking
Listening
Numeracy
Cultural and conceptual knowledge
Is health literacy different from general literacy?
Two two are very highly correlated
Reading fluency is a single domain
But, health knowledge often low and health materials often very difficult
Results in limited comprehension and application of information
⅓ of patients at 2 public hospitals had inadequate functional health literacy
⅓ of medicare managed care enrollees had low health literacy
Low literacy , within a circle of low health literacy
So even more low health literacy
Health literacy in the NAAL
Requested by US department of health and human services
28 of the 153 NAAL items
Results released in Sept 2006
Provides first national assessment of health literacy
Categories and sample health tasks
Proficient - calculate employee’s share of health insurance costs for a year
Intermediate - determine healthy weight range; medication timing
Basic - explain why it is difficult to know if they have a basic chronic condition
Below basic - identify what is permissible to drink before a medical test
Health literacy in america: results from the NAAl
12% proficient, 53% intermediate, 36% basic or below basic
100+ million adults have basic or below basic health literacy (2006)
By age - 59% of adults >65 yo basic or below basic
By education - 76% of those that didn’t graduate high school basic or below basic
and 44% high school graduates
By race ethnicity - hispanic 66%, black 58%, whites 28% basic or below
Underserved populations have lowest health literacy skills
Elderly
Minorities
Immigrants
The poor
The homeless
Prisoners
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Document Summary

To increase familiarity of the evidence of health literacy and its impact on health. Emphasis placed on the state of the research on health literacy, identifying what we know, and what gaps exist. Literacy in america: national assessment of adult literacy (naal) National sample survey conducted in 2003 and 1992. Performed by us department of education, national center for health statistics. In person interviews with americans age 16 and older. Emphasized the use of printed everyday materials (newspapers, prescriptions, bills) needed to function adequately in one"s environment. 153 items that assessed prose, document or quantitative literacy. Most items required searching text for specific information, short written responses. Below basic: no more than the most simple and concrete literacy skills. 93 million adults have basic or below basic literacy (43%) Hispanic and blacks are the most illiterate. Nearly of ga adults may be illiterate. Grade level completion does not correlate to actual reading level: adults with.

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