Transcript Literacy and Cost - Georgia Health Grantmaking
Health Literacy: Tools You Can Use
Julie Gazmararian, PhD, MPH Kara Jacobson, MPH, CHES Department of Health Policy and Management Rollins School of Public Health Emory University
Overview
Overview of health literacy
• •
Definition Prevalence
•
Impact
Strategies for improved communication
• •
Tools Assessment
Open discussion
National Adult Literacy Survey (NALS)
“Using printed and written information to function in society, to achieve one’s goals, and to develop one’s knowledge and potential” (National Literacy Act of 1991)
Prose, Document, Quantitative
NALS 2003 Results
Quantitative 22% 33% 33% 13% Prose 14% 29% 44% 13% Below Basic Intermediate Proficient
National Adult Literacy Study, 2003
Health Literacy
Healthy People 2010
Objective 11-2: Improve health literacy Objective 17-3: Increase review with older patients newly prescribed and OTC medications AHRQ Evidenced-based review of health literacy IOM
Priority Areas for National Action: Self-management/Health literacy Report from Committee on Health Literacy
What is Health Literacy?
In this report, the committee accepted the definition of health literacy presented by the National Library of Medicine:
The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
(Selden et al. 2000; Healthy People 2010, HHS 2000; Ratzan & Parker 2000)
What is Health Literacy?
Not only reading skill….BUT ALSO
Writing
Speaking
Listening
Numeracy
Cultural and Conceptual knowledge
"The health of our country depends on our understanding of basic health information in order to lead a healthy life"
U.S. Surgeon General Carmona
Low “health” literacy Low literacy
39
1 out of 4 1 out of 3
Health Literacy Challenges
Most people cannot understand health information they need
It’s hard to be a patient these days and it’s easy to mess up
An issue of quality — essential for self-management, reducing disparities and reducing costs
Problems Associated with Low Health Literacy
Poor health status
Compliance with medication
Knowledge of basic self-care
Follow-up visits
Hospitalizations
Physician visits
Comprehension of informed consent, medical forms, insurance benefits
Costs
Health Outcomes Associated with Literacy
General health status Hospitalization Emergency department use Prostate cancer stage Depression Diabetes control HIV control Mammography Pap smear Pneumococcal immunization Influenza immunization STD screening
Behavioral Outcomes Associated with Literacy
Substance abuse
Breastfeeding
Behavioral problems
Adherence to medication
Smoking
Knowledge-related Outcomes Associated with Literacy
Birth control knowledge
Cervical cancer screening
Emergency department instructions
Asthma knowledge
Hypertension knowledge
Does Inadequate Literacy Lead to Excess Medicare Hospital Costs?
36 Million Medicare Eligible 44% Functionally Illiterate (16 million) $ 2,262 per Person / Year 25% - 50% Higher Hospital Costs Excess Hospital Costs = $8 - $15 BILLION
The main problem with communication is the assumption that it has occurred.
George Bernard Shaw