Health skills: citizens and professionals

1. Health skills: citizens and professionals

2. Maarten LemminkAlette BroekensGGD Haaglanden/Municipalhealth service

3. Health skills, health literacy

4. Why put a focus on health skills? Positive Health: The ability to adapt and to self manage in the face of social, physical and emotional challenges. Age Friendly City: A city in which senior citizens can live a self-reliant, active and purposeful life.  Common Focus • “Health Skills” are needed to make that possible. • We prefer to speak about “health literacy” skills.

5. Definition health literacy The cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health.

6. What do we know about health literacy in The Hague? • 29% of the Dutch adult population has (very) poor health literacy skills. • are not able to obtain, process and understand health information needed to make informed health decisions • have trouble getting control on health, illness and care • have lack of knowledge, motivation and self-confidence • Risk groups especially are men, the elderly, migrants, low literacy, people with light mental handicap, with a lower education and lower income. • Low literacy: • 2,5 million of Dutch adults are low literate. • In The Hague: on average 24% of the adults are low literate. • Elderly people: low literacy increases sharply with age. • > 55 years: 20% is low literate. • Among the elderly: Over-representation in Loosduinen (30% of the population) and Scheveningen (21%).

7. Socio-economic health disparities • Low (health) literacy is one of the most important causes of a low socio-economic status. • On average do people with a low socio-economic status live 7 years shorter and 19 years less in good perceived health. • They suffer from more diseases than people with a high socio-economic status: • Asthma and COPD, diabetes, cancer, heart disease and mental health problems at these groups significantly more common. • Also we see differences in mortality risk: Elderly people with limited health skills have a one to two times higher chance of premature mortality than elderly with adequate health skills.

8. Health literacy skills We can divide 3 types of skills: • Functional (such as reading and writing, arithmetic, searching the internet) • Interactive or communicative (such as understanding of what you read, abstract thinking, being able to differentiate between main- an less important issues, reflective skills) • Critical (such as application of information, organizing of the information, thinking ahead, setting priorities)

9. What are consequences of low health literacy skills ? One out of two Dutchmen has trouble with self management. They have trouble with: • Diseases caused by unhealthy lifestyle • insight into possible causes of sickness • naming possible treatments • trouble asking questions to care provider • Use of medication (e.g. know how to take them in the right way) • less confidence in self treatment

10. Health literacy gap: People do not receive the health care they need Challenge for individuals: • to find their way in the health care system • difficulties to find, understand, assess and use information on their own health or that of their family members Challenge for professionals/organizations: - recognizing low health literate people • to get and give information across in plain language • to ask the right questions to get a clear picture of a patient’s situation

11. Vision of public health service municipal Goal of the interference of GGD: Diminishing of the health literacy gap in Haaglanden Region How does the GGD want to achieve that: • Agenda setting: • Raising awareness about health literacy among policy makers, health professionals, health care institutions and the general public • Sample setting: Practise what you preach! • Collaboration: • Facilitating exchange of knowledge and expertise of people and organizations working in the health sector and other social sectors • Integrating health literacy issues in education, research and patient participation and –experiences

12. Trial and Error of GGD Examples • Collaboration between GGD, LUMC,HMC hospital - research: cancer screening in The Hague. The influence of social and cultural differences and health literacy on decision making. • Health dialogue finding a solution for the low succes of health promotion interventions in the district of Schilderswijk in collaboration with residents of the deprived Schilderswijk and health professionals • Health monitor research, advise and agendasetting for the local health policy • Health for asylum seekers: collaboration with language providers to include health issues (e.g. getting to know the Dutch health system) • Making use of key persons in health prevention activities: example: developing and testing of educational materials, giving training, …

13. Do’s and dont’s • Culture sensitive approach of professionals https://www.youtube.com/watch?v=ZsX0ha_rIBg • Individual approach • Proper Language • Use of Narratives • Communication through graphic communication and example behaviour • Listening attitude

14. Discussion • First impression • Comparison with other cities/countries • Health Literacy is a matter of individuals AND professionals • Health Literacy is yet poorly understood • Health Literacy should be a high priority in an Age Friendly Approach

15. Questions? Maarten Lemmink maarten.lemmink@ggdhaaglanden.nl Alette Broekens alettebroekens@ggdhaaglanden.nl