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Health Literacy

TOP - August 2014, Vol 7, No 3

As originally defined by researchers with the National Library of Medicine in 2000, health literacy is “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”1 In advance of the October observance of Health Literacy Month, here is additional information regarding this important issue.

In 2003, more than 19,000 Americans aged 16 years and older participated in the National Assessment of Adult Literacy, which included, for the first time, a health literacy component. Health literacy was reported using 4 performance levels: Below Basic, Basic, Intermediate, and Proficient. Rates reported were2:

  • Intermediate 53%
  • Basic 22%
  • Below Basic 14%
  • Proficient 11%

In 2010, the US Department of Health and Human Services released the National Action Plan to Improve Health Literacy, which includes 7 goals3:

  1. Develop and disseminate health and safety information that is accurate, accessible, and actionable.
  2. Promote changes in the healthcare system that improve health information, communication, informed decision making, and access to health services.
  3. Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through the university level.
  4. Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community.
  5. Build partnerships, develop guidance, and change policies.
  6. Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy.
  7. Increase the dissemination and use of evidence-based health literacy practices and interventions.
    On its Health Literacy website, the Centers for Disease Control and Prevention lists health literacy activities for 20 states.4

From July 1, 2009, through June 30, 2012, Rutgers University School of Nursing and the Ironbound Community Corporation (ICC) collaborated on health literacy classes for non–English-speaking Latino immigrants in a Newark, New Jersey, neighborhood. The ICC held 6 sessions of Spanish-language health literacy classes, each lasting between 8 and 12 weeks. A total of 64 participants attended at least 80% of the classes, and most participants reported increased ability to access needed health services. About one-third of the agency’s staff were trained to identify and support clients with low health literacy, and the university updated its curriculum to include health literacy.5

In a recent small study of 65 patients and 30 nurses, results demonstrated that nurses were 6 times as likely to overestimate rather than underestimate patients’ health literacy.6


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