Transcript Medi-Cal Access Project - Saint Louis University

Role of Community Organizations
to Improve Health Literacy
Linda Neuhauser, DrPH
St. Louis Univeristy
St. Louis, MO
October 15, 2010
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Today’s Discussion
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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
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Health Literacy is Empowerment
It’s about using information to take control
and create a healthy life
Why is Health Literacy a Problem?
Health Literacy Skills are Low in the US
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U.S. high school dropout rate is 30%
The Demands of the Health System Are
Too High for Most People:
•
•
•
•
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Learning about prevention
Understanding advice from the media
Using health care
Dealing with insurance
National Assessment of Adult Literacy, 2003
Below Basic: No more than the most simple & concrete literacs
Basic:
Can perform simple everyday literacy activities
Intermediate: Can perform moderately challenging literacy
activities
Proficient:
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Can perform complex and challenging literacy
How well do patients understand how to take their
medicine or prepare for a medical procedure?
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The US health system only works for
12% of Americans
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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.
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A Patient’s Story
(AMA video)
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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 the
10-12th grade level.
Mismatched Communication
Information is too complicated for
people’s health literacy abilities
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After a Clinical Encounter, Patients may…
Forget or misunderstand 50% of what
the physician said
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
Estimated annual costs of low health
literacy to the economy
U.S.
$106 to $238 billion
Vernon J. et al, 2007
Health Literacy Is…
A better predictor of health status than
income, race/ethnicity, age, education level
or employment
Socio-Ecological
Model
Government
Media
Congress
New
Media
Policy
Community
Library
Adult
Literacy
School
HealthCare
Hospitals
Pharmacy
Family
Person
CBO
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
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?”
Community Projects to
Improve Health Literacy
Health Literacy Missouri
Fathers’ Support Center’s
Family Formation Program
Group discussion about lessons learned from the
Straight Talk with Your Doc Workshop
Standardized Patient Encounter-University of Missouri
Project Know at The Kitchen Clinic