Low Literacy and Health
Today's health care system is becoming ever more difficult to navigate. We've all experienced the difficulties and frustrations sifting and sorting through insurance packages, deciphering qualification requirements, and making program choices. Then comes the joy of making an appointment to see a physician, filling out the insurance information, completing all the medical questionnaires and explaining what ails you in 20 words or less when you finally get your 10 minutes with the actual physician. Finally, there is trying to understand what the physician said, deciphering any written medical information (usually filled with plenty of medical terminology and jargon), and complying with any medication regime. So if we, the literate population, find it it this difficult to make "heads or tales" out of the medical care we receive, how does the low-literate population manage?
Low literacy issues, in relation to the health care industry, have long been a problem in the United States. However, in the last decade, "Literacy and Health" issues seem to be gaining more national attention. Issues such as readability of informed consent forms, medical history forms, diagnosis materials, treatment and medication regiments, and home care issues are all items being addressed. Non-compliance due to the lack of the ability to clearly understand or comprehend verbal or written medical advice, by low literacy or limited literacy individuals, has been identified as a cause for increased hospital care in this population.
Currently, many organizations and groups are addressing literacy and health
issues. Work is being done to educate physician and patient alike, creating
ways to improve respective communication practices. The American Medical
Association (AMA) has recently initiated a "Cultural Competence Initiative" to
increase awareness for global physician/patient communication skills (this
report is available on-line at http://www.ama-assn.org).
Section II of this report offers help finding medical translation services
and contains selected reports and listings of annotated bibliographies
covering this issue. Additionally, the AMA has created a consumer medical
information Web site http://www.ama-assn.org/consumer.htm,
a "Public Health" site http://www.ama-assn.org/ethic/cahp/pubhlth.htm,
and a Health Literacy Introduction Kit, for medical care professionals,
which is available by calling Kristin S. Gover at 312-464-5357. (The kit
costs $15.00 for members and $25.00 for non-members.) The National Institute
for Literacy's Health & Literacy Online Discussion List is another
pioneering effort in Health and Literacy issues. The members of this Listserv
are both educators and health professionals. The topics covered are wide-ranging
and the information exchanged is timely and relevant. (To subscribe to
the list, e-mail LISTPROC@LITERACY.LINCS.GOV).
Archives of discussions from 1996 to 2000 may be accessed at
Additional aid to support Literacy and Health issues comes from private companies who contribute financial aid and other in-kind resources and services in the effort to build literacy. Pfizer U.S. Pharmaceuticals has recently published a series of literacy articles in "Responding to the Challenge of Health Literacy" which can be seen on their Web site. http://www.pfizer.com/pfizerinc/about/pubs/journal/journal5/coverpage.html#menu
TCALL staff are currently visiting health-related Web sites, assessing their readability levels and user accessibility. Thus far, almost all sites have included a means to submit comments to the editor of the site. As most of these sites probably do not employ a full-time adult educator to review materials placed for the general public, readers of this newsletter can take the opportunity to respond to designers of these Web sites about the sites' readability and accessibility to low-literate adults. If each reader would respond to at least one health-related Web site during the first annual National Health Literacy Month this October, perhaps we could contribute to making these resources "literacy friendly."
About the Author
Cheryl Heitzman is currently a Graduate Assistant with the Texas Center for Adult Literacy and Learning. She has a master's degree in Education with an emphasis in Educational & Human Resource Development from Texas A&M University in College Station, Texas. Cheryl is currently working on her Ph.D. at Texas A&M University with an emphasis in Adult Education, which she hopes to finish in the next 2 years and become a professor of Adult Education at either the Junior College or University level. Her undergraduate degree is in Occupational Education from Southwest Texas State University in San Marcos. She enjoys reading and writing about adult education issues and is primarily concerned with the issues relating to health care and low-literacy skills. Originally from San Antonio, Cheryl now lives in Bryan-College Station with her dog and a very talkative bird. In her spare time she enjoys cooking and traveling which may be a result of the many interesting places she had the opportunity to visit during her childhood, as her parents were in the military. She enjoys surfing the Net and sharing all the many interesting sites she visits with her friends.
Low Literacy & Health: How Can This Apply to Project-Based Learning?
"How is everyone today?" Just ask this question of adult learners, and you may begin to hear accounts of children home from school with a virus, injuries sustained in the workplace, or problems with chronic health issues such as migraines, asthma, or high blood pressure. Lead these discussions a little deeper, and you'll undoubtedly get into issues with health insurance or Medicaid, problems accessing health care services, or difficulty deciphering instructions for prescription medications. You may even find students discussing concerns about the impact of the local environment on their families' health.
Any of these casual discussions could lead to a variety of student-developed classroom projects. For example, parents in a workplace GED class might research the availability of low-cost or free health insurance for children in working families. An Internet search could lead them to sites such as http://www.insurekidsnow.gov/, which has information both in English and Spanish on CHIP (Children's Health Insurance Program) coverage. Learners could research who is eligible and how parents sign up in your local community. A class could invite a local health care provider or Health Department representative to talk about the CHIP program and discuss preventive health care for infants and children. A classroom project could also include outreach to the community, to make others aware of CHIP.
As you can see from just one example, the possibilities are endless, and the benefits to learners and their families include not only opportunities to learn and utilize literacy skills, but also to improve their health and that of their families.
Health Literacy Month
Health Literacy Month is to be held for the first time in October 2000. It is a grass-roots campaign to raise awareness about health literacy and promote understandable health communication across the world. The initial goals of Health Literacy Month are to 1) create a collective voice of health literacy advocates, and 2) exchange information advocates can use at a local level. Visit http://www.prenataled.com/healthlit/healthlit-1.htm