What is health literacy? What are community organizations doing ?

1. Role of Community Organizations to Improve Health LiteracyLinda Neuhauser, DrPH St. Louis UniveristySt. Louis, MOOctober 15, 2010

2. Today’s Discussion • What is health literacy? • What are community organizations doing ? • What are can communities do in the future?

3. Health 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

4. Health Literacy is Empowerment It’s about using information to take control and create a healthy life

5. Why is Health Literacy a Problem?

6. Health Literacy Skills are Low in the US U.S. high school dropout rate is 30%

7. 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

8. National Assessment of Adult Literacy, 2003 Below Basic: No more than the most simple & concreteliteracs Basic: Can perform simple everyday literacy activities Intermediate: Can perform moderately challenging literacy activities Proficient: Can perform complex and challenging literacy

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

10. The US health system only works for 12% of Americans

11. 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.

12. A Patient’s Story(AMA video)

13. US Reading Levels Compared to Health Information Readability • 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 the10-12th grade level.

14. Mismatched Communication Information is too complicated for people’s health literacy abilities

15. After a Clinical Encounter, Patients may… • Forget or misunderstand 50% of what the physician said

16. 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

17. Estimated annual costs of low health literacy to the economy U.S. $106 to $238 billion Vernon J. et al, 2007

18. Health Literacy Is… A better predictor of health status than income, race/ethnicity, age, education level or employment

19. Socio-Ecological Model Government Media Congress New Media Policy Community Library School HealthCare Adult Literacy CBO Hospitals Pharmacy Family Person

20. Module 1 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

21. 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?”

22. Community Projects to Improve Health Literacy

24. Health Literacy Missouri

25. Fathers’ Support Center’s Family Formation Program

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

27. Standardized Patient Encounter-University of Missouri

28. Project Know at The Kitchen Clinic