HLTH 210 Lecture Notes - Lecture 12: Natural-Born-Citizen Clause, Ministry Of Statistics And Programme Implementation, Managed Care
7 May 2018
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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
find more resources at oneclass.com
find more resources at oneclass.com
○ 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 ⅙, within a circle of low health literacy ⅓
○ 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
find more resources at oneclass.com
find more resources at oneclass.com
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.
