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[toggle_content title=”Populations at Increased Risk for Low & Limited Health Literacy”]
| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 1 | Populations most likely to experience low health literacy are older adults, racial and ethnic minorities, people with less than a high school degree or GED certificate, people with low income levels, non-native speakers of English, and people with compromised health status. | National Center for Education Statistics. 2006. The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy. Washington, DC: U.S. Department of Education. | ||
| 2 | Individuals who are less educated, have less money, and are minorities are more likely to have inadequate health literacy. | Paasche-Orlow, M.K. & Wolf, M.S. (2007). The causal pathways linking health literacy to health outcomes. American Journal of Health Behavior, 31, 19-26. |
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[toggle_content title=”Barriers to individual Understanding of Health Information”]
| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 3 | Low health literacy may deter people from seeking treatment due to fear and confusion. | Baker, D. W., Gazmararian, J. A., Mark V. Williams, J. A., Scott, T., Parker, R. M., Green, D., & … Peel, J. (2004). Health Literacy and Use of Outpatient Physician Services by Medicare Managed Care Enrollees. JGIM: Journal Of General Internal Medicine, 19(3), 215-220. doi:10.1111/j.1525-1497.2004.21130.x | low literacy, understanding health information, health outcomes | |
| 4 | Low health literacy may also have negative psychological effects. One study found that those with limited health literacy skills reported a sense of shame about their skill level. | Parikh NS, Parker RM, Nurss JR, Baker DW, Williams MV. (1996). Shame and health literacy: The unspoken connection. Patient Education and Counseling. 27(1), 33-39. | stigma and shame | |
| 5 | Those with limited health literacy skills may hide reading or vocabulary difficulties to maintain their dignity. | Baker DW, Parker MR, Williams MV, Ptikin K, Parikh NS, Coates W, Imara M. (1996). The health care experience of patients with low literacy. Archives of Family Medicine.5(6), 329-334. | stigma and shame | |
| 6 | Many patients work hard to hide the fact that they have trouble understanding something they are told or given to read because they are embarrassed and/or do not want to appear to challenge the healthcare provider in any way. | Barrett, S. E., & Sheen Puryear, J. (2006). Health literacy: Improving quality of care in primary care settings. Journal of Health Care for the Poor and Underserved. 17(4), 690-697. | stigma and shame | |
| 7 | Patients with low health literacy may avoid asking questions when medical information is not clear to them. | Neilsen-Bohlman, L., Panzer, A. M., & Kindig, D. A. (2004). Health literacy: A prescription to end confusion. Washington, DC: National Academies Press. | stigma and shame |
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[toggle_content title=”Consequences of Low & Limited Health Literacy”]
| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 8 | Parents with below-basic health literacy were more likely to have a child without health insurance in their household. | Yin HS, Johnson M, Mendelsohn AL, Abrams MA, Sanders LM, Dreyer BP. (2009). The health literacy of parents in the United States: a nationally representative study. Pediatrics. 124(Suppl 3): S289-S298. doi:10.1542/peds.2009-1162E | health literacy of parents, understanding health conditions, understanding health information, youth | |
| 9 | Parents with below-basic health literacy had 3.4 times the odds of reporting difficulty understanding over-the-counter medication labels. | Yin HS, Johnson M, Mendelsohn AL, Abrams MA, Sanders LM, Dreyer BP. (2009). The health literacy of parents in the United States: a nationally representative study. Pediatrics. 124(Suppl 3): S289-S298. doi:10.1542/peds.2009-1162E | health literacy of parents, understanding health conditions, understanding health information, youth | |
| 10 | Among 659 public hospital patients, those with poor health literacy skills were five times more likely to misinterpret their prescriptions than those with adequate skills. | Mark V. Williams, Ruth M. Parker, David W. Baker, Nina S. Parikh, Kathryn Pitkin, Wendy C. Coates, Joanne R. Nurss (1995). Inadequate Functional Health Literacy among Patients at Two Public Hospitals. Journal of the American Medical Association. 274(21): 1677-1628. doi: 10.1001/jama.1995.03530210031026 | medications, prescription labels, understanding health conditions, understanding health information | |
| 11 | HIV-positive adults with low functional health literacy missed more treatment doses than patients with high health literacy because they were confused by the instructions in a study of 182 patients. | Seth C Kalichman, Eric Benotsch, Troy Suarez, Sheryl Catz, Jeff Miller, David Rompa. (2000). Health Literacy and Health-Related Knowledge among Persons Living with HIV/AIDS. American Journal of Preventive Medicine. 18(4): 325-331. doi: 10.1016/S0749-3797(00)00121-5. | medications, HIV, chronic disease management, understanding health conditions, understanding health information | |
| 12 | According to research studies, persons with limited health literacy skills are more likely to skip important preventive measures such as mammograms, Pap smears, and flu shots. | Scott TL, Gazmararian JA, Williams MV, Baker DW. (2002). Health literacy and preventive health care use among Medicare enrollees in a managed care organization. Medical Care. 40(5): 395-404. | understanding health information, understanding health conditions, prevention, health outcomes | |
| 13 | When compared to those with adequate health literacy skills, studies have shown that patients with limited health literacy skills enter the healthcare system when they are sicker. | Bennet CL, Ferreira MR, Davis TC, Kaplan J, Weinberger M, Kuzel T, Seday MA, Sartor O. (1998). Relation between literacy, race, and stage of presentation among low-income patients with prostate cancer. Journal of Clinical Oncology. 16(9): 3101-3104. | understanding health information, understanding health conditions, prevention, health outcomes | |
| 14 | Studies have demonstrated a higher rate of hospitalization and use of emergency services among patients with limited literacy skills. | Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, Ren J, Peel J. (2002). Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. American Journal of Public Health. 92(8): 1278-1283. | prevention, health outcomes, hospitalization, emergency room utilization | |
| 15 | Limited health literacy skills are associated with an increase in preventable hospital visits and admissions. | Baker DW, Parker RM, Williams MV, Clark WS. (1997). The relationship of patient reading ability to self-reported health and use of health services. American Journal of Public Health. 87(6): 1027-1030.Baker DW, Parker RM, Williams MV, Clark WS. (1998). Health literacy and the risk of hospital admission. Journal of General Internal Medicine. 13(12): 791-798.Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, Ren J, Peel J. (2002). Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. American Journal of Public Health. 92(8): 1278-1283.Gordon MM, Hampson R, Capell HA, Madhok R. (2002). Illiteracy in rheumatoid arthritis patients as determined by the Rapid Estimate of Adult Literacy (REALM) score. Rheumatology. 41(7): 750-754. | prevention, health outcomes, hospitalization, emergency room utilization | |
| 16 | Studies demonstrate that persons with limited health literacy skills are significantly more likely than persons with adequate health literacy skills to report their health as poor. | Baker DW, Parker RM, Williams MV, Clark WS. (1997). The relationship of patient reading ability to self-reported health and use of health services. American Journal of Public Health. 87(6): 1027-1030.Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, Ren J, Peel J. (2002). Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. American Journal of Public Health. 92(8): 1278-1283.National Center for Education Statistics. 2006. The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. Washington, D.C.: U.S. Department of Education. | health status | |
| 17 | Studies demonstrate a higher rate of hospitalization and use of emergency services among patients with limited health literacy skills. | Baker DW, Parker RM, Williams MV, Clark WS. (1997). The relationship of patient reading ability to self-reported health and use of health services. American Journal of Public Health. 87(6): 1027-1030.Baker DW, Parker RM, Williams MV, Clark WS. (1998). Health literacy and the risk of hospital admission. Journal of General Internal Medicine. 13(12): 791-798.Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, Ren J, Peel J. (2002). Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. American Journal of Public Health. 92(8): 1278-1283.Gordon MM, Hampson R, Capell HA, Madhok R. (2002). Illiteracy in rheumatoid arthritis patients as determined by the Rapid Estimate of Adult Literacy (REALM) score. Rheumatology. 41(7): 750-754. | prevention, health outcomes, hospitalization, emergency room utilization | |
| 18 | Problems with patient compliance and medical errors may be based on poor understanding of health care information. Only about 50% of all patients take medications as directed. | Center for Health Care Strategies, Inc. Health Literacy and Understanding Medical Information Fact Sheet. 1997. | understanding health conditions, understanding health information, medication errors | |
| 19 | Patients with low health literacy and chronic diseases, such as diabetes, asthma, or hypertension, have less knowledge of their disease and its treatment and fewer correct self-management skills than literate patients. | Williams MV, Baker DW, Honig EG, Lee TM, Nowlan A. (1998). Inadequate literacy is a barrier to asthma knowledge and self-care. Chest. 114(4). 1008-1015. doi: 10.1378/chest.114.4.1008 | understanding health conditions, understanding health information | |
| 20 | Patients with low literacy skills were observed to have a 50% increased risk of hospitalization, compared with patients who had adequate literacy skills. |
Baker DW, Parker RM, Williams MV, Clark WS. (1998). Health literacy and the risk of hospital admission. Journal General Internal Medicine. 13(2): 791-798. doi:10.1046/j.1525-1497.1998.00242.x | health outcomes, hospitalization | |
| 21 | consequences of low health literacy & Literacy level | Health outcomes are related to health literacy. Studies have shown that patients with low health literacy have trouble understanding health information and getting preventative health care. These patients may use emergency rooms and other expensive health services more often than patients with higher health literacy skills. | Nielsen-Bohlman, L., Panzer, A. (2004). Health Literacy: A Prescription to End Confusion. Board on Neuroscience and Behavioral Health, Institute of Medicine.Washington, DC: National Academies Press; 2004. | understanding health conditions, understanding health information, health outcomes, hospitalization, prevention |
| 22 | Adults need health literacy skills to speak with medical professionals, access health information, follow dosage instructions, interpret charts, make informed health decisions, and use medical tools for personal or family health care. | Nielsen-Bohlman, L., Panzer, A. (2004). Health Literacy: A Prescription to End Confusion. Board on Neuroscience and Behavioral Health, Institute of Medicine.Washington, DC: National Academies Press; 2004. | ||
| 23 | consequences of low health literacy & Literacy level | Reading skill was the strongest predictor of asthma knowledge in a study of 483 patients. Only 11% of those reading below a third-grade reading level could use their metered dose inhaler correctly. | Williams MV, Baker DW, Honig EG, Lee TM, Nowlan A. (1998). Inadequate literacy is a barrier to asthma knowledge and self-care. Chest. 114(4). 1008-1015. doi: 10.1378/chest.114.4.1008 | medications, asthma, chronic disease management, understanding health conditions, understanding health information |
| 24 | Patients with limited health literacy may face greater difficulty in reading and interpreting labels on prescription drug bottles. | Davis TC, Wolf MS, Bass PF, Middlebrooks M, Kennen E, Baker DW, Bennett CL, Durazo-Arvizu R, Bocchini A, Savory S, and Parker RM. (2006). Low Literacy Impairs Comprehension of Prescription Drug Warning Labels. Journal of General Internal Medicine.21(8):847-851. doi: 10.1111/j.1525-1497.2006.00529.x | Prescription interpretation, medication errors | |
| 25 | Without clear information and an understanding of the information’s importance, people are more likely to skip necessary medical tests, end up in the emergency room more often, and have a harder time managing chronic diseases like diabetes or high blood pressure. | Rudd, R . E., Anderson, J . E., Oppenheimer, S., & Nath , C. (2007). Health literacy: An update of public health and medical literature. In J. P. Comi ngs, B. Garner, & C. Smith. (E ds.), Review of adult learning and literacy (vol . 7) (175–204). Mahwa h, NJ: Lawrence Erlbaum Associates. | understanding health information, chronic disease management, understanding health conditions, prevention, health outcomes | |
| 26 | Patients with low health literacy have more difficulty understanding prescription drug information, and that they often experience mediation -related problems after hospital discharge. | Maranova, M., Roumie, C., Eden, S., Cawthon, C., Schinipper, J., Kripalani, S. (2011). Health Literacy and Medication Understanding Among Hospitalized Adults. Journal of Hospital Medicine. 6(9): 488-493. | ||
| 27 | Lower health literacy is associated with increased risk of death after hospitalization for acute heart failure. | McNaughton, C. D., Cawthon, C., Kripalani, S., Liu, D., Storrow, A. B., and Roumie, C. L. (2015). Health literacy and mortality: A cohort study of patients hospitalized for acute heart failure. Journal of the American Heart Association, 4(5). doi:10.1161/jaha.115.001799. | Health literacy, health services research, health failure, mortality | |
| 28 | Parents with low health literacy are less likely to choose government-recommended child weight loss strategies. | Liechty, J. M., Saltzman, J. A., and Musaad, S. M. (2015). Health literacy and parent attitudes about weight control for children. Appetite, 91:200-208. | Parents, health literacy, child obesity |
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[toggle_content title=”Impact of Low & Limited Health Literacy on Annual Health Care Expenditures”]
| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 29 | The cost of low health literacy: – Annual cost today: $106-238 billion – Future costs based on today’s actions or inactions: $1.6-3.6 trillion |
Vernon, J, Trujillo, A, Rosenbaum, S, DeBuono, B. (2007) Low Health Literacy: Implications for National Health Policy. Univeristy of Connecticut. National Bureau of Economic Research. Storrs, CT. | cost of low health literacy, health costs, impact | |
| 30 | Low health literacy is an enormous cost burden on the American healthcare system – annual health care costs for individuals with low literacy skills are 4 times higher than those with higher literacy skills. |
Weiss, B. (1999). 20 Common Problems in Primary Car. New York, NY: McGraw Hill. 468-481. | cost of low health literacy, health costs, impact |
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[toggle_content title=”Support for Improving Health Literacy”]
| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 31 | Increasing health literacy may be the most effective and direct approach to improving health status and decreasing hospital and emergency room use among the aging. | Cho, Y., Lee, S., Arozullah, A., Crittenden, A. (2008) Effects of health literacy on health status and health service utilization amongst the elderly. Social Science & Medicine. 66(8):1809-1816. | low literacy, understanding health information, elderly, older adults, health outcomes | |
| 32 | Improving health literacy for all Americans has been identified as one of the 20 necessary actions to improve health care quality on a national scale. | Adams K,. (2003). Priority areas for national action: transforming health care quality. Corrigan J, (Ed.).Washington, DC: The National Academies Press. | improving health literacy | |
| 33 | Anyone can have low health literacy, including people with good literacy skills. In fact, most people will have trouble understanding health information at some point in their lives. For example, people experiencing serious health problems may come across specific medical terms or health information for the first time. | Nielsen-Bohlman, L., Panzer, A. (2004). Health Literacy: A Prescription to End Confusion. Board on Neuroscience and Behavioral Health, Institute of Medicine.Washington, DC: National Academies Press; 2004. |
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[toggle_content title=”How Literacy & Readablity Impact Understanding of Health Information”]
| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 34 | Literacy Levels / readability & consequences of Low Lit | Literacy level appears to be an important determinant of patients’ participation in the medical encounter. Low-literacy patients ask fewer questions about their medical care, and this may affect their ability to learn about their medical conditions and treatments. | Katz MG, Jacobson TA, Veledar E, Kripalani S. (2007). Patient literacy and question-asking behavior during the medical encounter: a mixedmethods analysis. Journal of General Internal Medicine. 22(6):782-6. |
literacy level, asking questions, understanding health conditions, understanding health information |
| 35 | You can’t expect patients to tell you: – 75% of patients with low literacy do not tell their health care providers – 85% do not tell coworkers – 68% do not tell spouse |
Parikh NS, Parker RM, Nurss JR, Baker DW, Williams MV. (1996). Shame and health literacy: The unspoken connection. Patient Education and Counseling. 27(1), 33-39. | low health literacy, assessing low health literacy, characteristics of people with low literacy | |
| 36 | Most health information is written at a 10th grade level or higher. | Doak C., Doak L., Root J.(1996). Teaching Patients with Low Literacy Skills (2nd ed.). Philadelphia, PA: JB Lippincott Company. | readability, reading grade level | |
| 37 | The average adult in the United States reads at about the sixth to eighth grade reading level, even if their total number of years of education far exceeds that grade level. | Wilson FL, Racine E, Tekieli V, Williams B. (2003). Literacy, readability and cultural barriers: Critical factors to consider when educating older African Americans about anticoagulation therapy. Journal of Clinical Nursing.12(2):275-282. doi:10.1046/j.1365-2702.2003.00711.x. | readability, reading grade level | |
| 38 | Even patients who read at the college level have been found to prefer medical information written at the 7th grade level. | Davis, T., Crouch, M., Wills, G., Miller, S., et al. (1990).The gap between patient reading comprehension and the readability of patient education materials. Journal of Family Practice. 31(5):533-538. |
readability, reading grade level | |
| 39 | It is recommended that health education materials developed for the general public should not exceed sixth to eighth grade levels. | Doak C., Doak L., Root J.(1996). Teaching Patients with Low Literacy Skills (2nd ed.). Philadelphia, PA: JB Lippincott Company. | readability, reading grade level | |
| 40 | It has been shown that it does not matter how high the reading ability of the targeted group might be; materials written at readability levels of sixth to eighth grade are more effective in conveying health messages and have higher rates of recall across all educational levels. | Davis, T., Mayeaux, E., Fredrickson, D., Bocchini, J., Jackson, R., Murphy, P. (1994). Reading ability of parents compared with reading level of pediatric patient education materials. Pediatrics. 93(4):460-468. | readability, reading grade level | |
| 41 | The vast majority of health education materials are written at readability levels that are far above the average person’s ability to comprehend (usually at least four grades higher than average readability). | Dowe, C., Lawrence, P., Carlson, J., Kerserling, T. (1997). Patients’ use of health teaching materials at three readability levels. Applied Nursing Research.10(2):86-93. | readability, reading grade level | |
| 42 | Three decades of research studies have consistently found that health materials exceed the reading ability of the intended audiences. | Rudd, R . E., Anderson, J . E., Oppenheimer, S., & Nath , C. (2007). Health literacy: An update of public health and medical literature. In J. P. Comi ngs, B. Garner, & C. Smith. (E ds.), Review of adult learning and literacy (vol . 7) (175–204). Mahwa h, NJ: Lawrence Erlbaum Associates. | readability, reading grade level | |
| 43 | One out of five American adults reads at the 5th grade level or below, and the average American reads at the 8th to 9th grade level, yet most health care materials are written above the 10th grade level. |
Doak C., Doak L., Root J.(1996). Teaching Patients with Low Literacy Skills (2nd ed.). Philadelphia, PA: JB Lippincott Company. | adult literacy, readability, reading grade level |
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[toggle_content title=”How Numeracy Impacts Individual Understanding of Health Information”]
| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 44 | Numeracy is an important component of health literacy and represents “the ability to understand and use numbers in daily life.” | Rothman, R., Housam, R., Weiss, H., et al. (2006). Patient understanding of food labels: the role of literacy and numeracy. American Journal of Preventive Medicine. 31(5):391-398. | numeracy | |
| 45 | Numeracy has been independently associated with health outcomes. | Huizinga, M., Beech, B., Cavanaugh, K., Elasy, T., Russell, R. (2008). Low numeracy skills are associated with higher BMI. Obesity.16(8):1966-1968. | numeracy | |
| 46 | Some individuals may have adequate print literacy but lack the numeracy skills needed to interact successfully with the health care system. | Kirsch, I., Jungeblut, A., Jenkins, L., et al. (1993). Adult literacy in America: a first look at the findings of the National Adult Literacy Survey (NCES 1993-275)(3rd ed.). Washington, DC: US Department of Education, Office of Educational Research and Improvement. | numeracy | |
| 47 | People with low numeracy skills cannot reliably carry out health-related tasks that rely on numeric information, such as interpreting food labels, measuring blood sugar, comparing risk information, or following dosing instructions for medications. | Rothman, R., Housam, R., Weiss, H., et al. (2006). Patient understanding of food labels: the role of literacy and numeracy. American Journal of Preventive Medicine. 31(5):391-398. | numeracy |
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[toggle_content title=”Seniors & Health Literacy”]
| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 48 | Inadequate functional health literacy (reading fluency) independently predicts overall mortality and cardiovascular mortality for community-dwelling persons over 65 years old. | Baker, D., Wolf, M., Feinglass, J., Thompson, J., Gazmararian, J., Huangm, J. (2007). Health Literacy and Mortality Among Elderly Persons. Archives of Internal Medicine. 167(14): 1503-1509. | low literacy, understanding health information, elderly, older adults, health outcomes | |
| 49 | The challenges of making sense of health information are especially great for the increasing proportion of people aged 65 years and older in the United States. | U.S. Department of Health and Human Services. (2007). Quick guide to health literacy and older adults. Washington, DC: Office of Disease Prevention and Health Promotion. | low literacy, understanding health information, elderly, older adults | |
| 50 | By 2030,there will be 71.5 million U.S. adults aged 65 years or older, which is more than twice their number in 2000. | U.S. Administration on Aging. Aging Statistics. (2010). Profile of Older Americans: 2010. Retrieved from: www.aoa.gov. | low literacy, understanding health information, elderly, older adults | |
| 51 | Older adults have more chronic illnesses and use more health care services than other segments of the population, and they face unique issues related to physical and cognitive functioning that can make it difficult for them to find and use appropriate health information. | Federal Interagency Forum on Aging-Related Statistics. (2008). Older Americans 2008: key indicators of well-being. Washington, DC: U.S. Government Printing Office. Retrieved from: www.agingstats.gov | low literacy, understanding health information, elderly, older adults | |
| 52 | More than 66% of US adults age 60 and over have either inadequate or marginal literacy skills. |
Doak C., Doak L., Root J.(1996). Teaching Patients with Low Literacy Skills (2nd ed.). Philadelphia, PA: JB Lippincott Company. | adult literacy | |
| 53 | Low health literacy in older Americans is linked to poorer health status and a higher risk of death. | Berkman, N., Sheridan, L. Donahue, K. et al. (2011). Health Literacy Interventions and Outcomes: An Updated Systematic Review, Evidence Report/Technology Assessment: Number 199. AHRQ Publication Number 11-E006-1. Agency for Healthcare Research and Quality, Rockville, MD. | low literacy, understanding health information, elderly, older adults, health outcomes, hospitalization, prevention | |
| 54 | Black Medicare patients less likely than whites to follow their doctor’s instructions on taking medicines. | Gerber, B., Cho, Y., Arozullah, A., Lee, S. (2010). Racial differences in medication adherence: A cross-sectional study of Medicare enrollees . American Journal of Geriatric Pharmacotherapy. 8(2) 136-145. | low literacy, understanding health information, elderly, older adults, health outcomes, medications, adherence, compliance, racial differences | |
| 55 | The elderly are more likely to have low health literacy skills compared to their younger counterparts due to a decline in their reading and cognitive abilities. | Baker, D., Gazmararian, G. A., Sudano, J., Patterson, M. (2000). The association between age and health literacy among elderly persons. Journals of Gerontology: Series B. 55(6), S368-S374. doi: 10.1093/geronb/55.6.S368 | low literacy, understanding health information, elderly, older adults | |
| 56 | Medicare enrollees with low health literacy are less likely to receive preventative health services such as vaccines and screenings. | Baker, D., Gazmararian, G. A., Sudano, J., Patterson, M. (2000). The association between age and health literacy among elderly persons. Journals of Gerontology: Series B. 55(6), S368-S374. doi: 10.1093/geronb/55.6.S368 | low literacy, understanding health information, elderly, older adults, prevention, health outcomes |
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[toggle_content title=”US Health Literacy Facts & Statistics”]
| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 57 | Among a national sample of eighth graders, 26% of students scored below the basic reading level score. | National Center for Education Statistics. (2004). The Nation’s Report Card: Reading Highlights 2003. Jessup, MD: US Department of Education. Retrieved from: http://nces.ed.gov/nationsreportcard/pdf/main2003/2004452.pdf | readability, reading grade level, teens, adolescents, youth | |
| 58 | A study of literacy related to health terms found that 46% of adolescents have basic or below basic health literacy skills. | Davis, T., Wolf, M., Arnold, C., Bryd, R., Long, S., Springer, T., Kennen, E., Bocchini, J. (2006). Development and validation of the rapid estimate of adolescent literacy in medicine (REALM-Teen): a tool to screen adolescents for below-grade reading in health care settings. Pediatrics.118(6):e1707–e1714. | health literacy and teens, reading grade level, teens, adolescents, youth | |
| 59 | The health literacy of parents in the United States: a nationally representative study: – More than 6100 parents made up the sample (representing 72,600,098 US parents) – 68.4% were unable to enter names and birth dates correctly on a health insurance form. – 65.9% were unable to calculate the annual cost of a health insurance policy on the basis of family size. |
Yin HS, Johnson M, Mendelsohn AL, Abrams MA, Sanders LM, Dreyer BP. (2009). The health literacy of parents in the United States: a nationally representative study. Pediatrics. 124(Suppl 3): S289-S298. doi:10.1542/peds.2009-1162E | health literacy of parents, understanding health conditions, understanding health information | |
| 60 | Nearly 100 million American adults have limited prose literacy (text such as a newspaper article) and lack the necessary basic skills to understand written health information. | Kutner, M., Greenberg, E., Jin,Y., Paulsen, C. (2006).The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006–483). Washington, DC: U.S.Department of Education National Center for Education Statistics. | low literacy, understanding health information | |
| 61 | Nearly half of all Americans, or 90 million people, have difficulty understanding and acting upon written or verbal health information. About one-third (29%) of adults 65 and older have below basic health literacy levels. | Kutner, M., Greenberg, E., Jin,Y., Paulsen, C. (2006).The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006–483). Washington, DC: U.S.Department of Education National Center for Education Statistics. | low literacy, understanding health information | |
| 62 | Nearly 9 out of 10 adults have difficulty using the everyday health information that is routinely available in our healthcare facilities, retail outlets, media and communities. | Kutner, M., Greenberg, E., Jin,Y., Paulsen, C. (2006).The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006–483). Washington, DC: U.S.Department of Education National Center for Education Statistics. | understanding health information | |
| 63 | The health of 90 million people in the U.S. may be at risk because of the difficulty some patients experience in understanding and acting upon health information. |
Kirsch, I., Jungeblut, A., Jenkins, L., et al. (1993). Adult literacy in America: a first look at the findings of the National Adult Literacy Survey (NCES 1993-275)(3rd ed.). Washington, DC: US Department of Education, Office of Educational Research and Improvement. | literacy level, understanding health conditions, understanding health information | |
| 64 | More than 77 million U.S. adults have basic or below basic health literacy skills. | Kutner, M., Greenberg, E., Jin,Y., Paulsen, C. (2006).The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006–483). Washington, DC: U.S.Department of Education National Center for Education Statistics. | ||
| 65 | Only 12 percent of adults have Proficient health literacy, according to the National Assessment of Adult Literacy. In other words, nearly nine out of ten adults may lack the skills needed to manage their health and prevent disease. Fourteen percent of adults (30 million people) have Below Basic health literacy. These adults were more likely to report their health as poor (42 percent) and are more likely to lack health insurance (28 percent) than adults with Proficient health literacy. | Kirsch, I., Jungeblut, A., Jenkins, L., et al. (1993). Adult literacy in America: a first look at the findings of the National Adult Literacy Survey (NCES 1993-275)(3rd ed.). Washington, DC: US Department of Education, Office of Educational Research and Improvement. |
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[toggle_content title=”Strategies to Assist Invdividuals with Low/Limited Health Literacy”]
| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 66 | Verbal patient education should always be accompanied by written information, for it enhances the clients’ understanding of what was taught and helps clients manage their own health care. | Gannon W, Hildebrandt, E. (2002). A winning combination: Women, literacy, and participation in health care. Health Care for Women International. 23(6-7):754-760. | literacy, patient education, printed materials, handouts, readability, understanding health conditions, understanding health information | |
| 67 | Provision of both verbal and written health information significantly increased knowledge and satisfaction scores. | Johnson, A., Sandford, J., Tyndall J. (2003). Written and verbal information versus verbal information only for patients being discharged from acute hospital settings to home. Cochrane Database of Systematic Reviews. 4: Art. No.CD003716. doi: 10.1002/14651858.CD003716 | literacy, patient education, printed materials, handouts, readability, understanding health conditions, understanding health information | |
| 68 | Instead of looking for new ways to “test” patients’ health literacy, a more practical and effective approach may be to produce more accessible and easier-to-understand materials for all patients. | Wilson-Stronks, A., Lee, K. K., Cordero, C. L., Kopp, A. L., Galvez, E. (2008). One size does not fit all: Meeting the health care needs of diverse populations. Oakbrook Terrace, IL: The Joint Commission. | screening, testing, identifying low health literacy skills | |
| 69 | Asking “How confident are you in filling out medical forms?” in either English or Spanish, may allow clinical researchers to identify persons with limited health literacy as effectively as using the English or Spanish versions of the short Test of Functional Health Literacy in Adults (s-TOFHLA). | Sarkar, U., Schillinger, D., Lopez, A., Sudore, R. (2011).Validation of self-reported health literacy questions among diverse English- and Spanish-speaking populations. Journal of General Internal Medicine. 26(3): 265-271. doi: 10.1007/s11606-010-1552-1 | screening, testing, identifying low health literacy skills |
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| Facts and Statements from Research | Source/Citation | Topics/Keywords | ||
| 70 | Health information websites are notorious for using overly complex and scientific language that makes the content difficult to understand and use. | Zarcadoolas, C., Pleasant, A. F., & Greer, D. S. (2006). Advancing health literacy: A framework for understanding and action. San Francisco, CA: Jossey-Bass. |
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