Are you health illiterate?

Are you health illiterate?

CBC Radio: 7.27.2015 by Dr. Brian Goldman

Modern medicine is complicated, which is what smart doctors are for, right? Well, maybe not. More and more experts think the key to better outcomes is a smarter patient - one who is informed about personal health. An article published last week says doctors should dumb down their instructions to patients. I think that idea is even dumber.

The article - by doctors at Thomas Jefferson University in Philadelphia - says that doctors should assume that in general, patients do not understand medical advice.  In other words, until proven otherwise, doctors should assume that patients are illiterate in health information.  Therefore, they should avoid using medical jargon when explaining diagnosis or treatment to the patient - unless the jargon is essential, in which case it should be explained clearly.  The authors also say that in general, when doctors talk to patients, they should speak or provide written handouts aimed at the grade five or six level.  When speaking, the authors say doctors - should - speak - slowly - and break down information into small manageable steps.  There's a lot more, but you get the drift.

The authors say studies show that more than a third of adults living in the U.S. have limited health literacy, making it more difficult for them to read, understand and apply health information.  That includes information presented on medication bottles, hospital discharge instructions, consent forms patients sign prior to surgery, medical forms, and health education handouts.  Studies show that more than 75% of patient educational materials are written at a high school or college reading level - far above the average American patient.  I have no reason to think Canadian patients fare any better at reading comprehension.  Patients don't understand a lot of the words doctors use. They also don't understand the way we use numbers.

It's disturbing to realize that doctors and patients overestimate how much patients are capable of absorbing.  Turns out there are real tools out there that assess health literacy. REALM-R is a word recognition test in which patients are asked to de-code or pronounce medical words like anemia, jaundice and colitis. It screens for poor literacy skills.  The Short Test of Functional Health Literacy in Adults assesses reading comprehension and numeracy skills over two prose passages and four items assessing numerical ability.  There's also a longer version of this test with three prose passages followed by a 50-item reading comprehension section.  The Single Item Literacy Screener has just one question:  How often do you need to have someone help you when you read instructions, pamphlets or other written material from your health professional or pharmacy.

Poor health literacy contributes to lower health standards and health disparities between informed and uninformed patients.  Poor health literacy has been cited as a factor in patients not following doctor's instructions, not taking medication properly and often not taking it at all. Studies show health illiteracy leads to longer stays in hospital and rising rates of poorly managed chronic diseases like type 2 diabetes and high blood pressure.  It leads to lower success rates curing cancer.  Not surprisingly, it also leads to bad health outcomes and in some cases to higher mortality rates.  READ MORE !

Health Literacy Screening Tools / Studies  (pdf)

Title of Screening Tool

     Rapid Estimate of Adult Literacy in Medicine (REALM)

     Rapid Estimate of Adult Literacy in Medicine - Revised (REALM-R)

     Test of Functional Health Literacy in Adults (TOFHLA)

     Short Test of Functional Health Literacy in Adults (S-TOFHLA)

     Newest Vital Sign (NVS)

     Brief Estimate of Health Knowledge and Action – HIV Version

     Single Item Literacy Screen

     How confident are you filling out medical forms by yourself?

     SOS Mnemonic

Description and Average administration time

Measurement of literacy levels

Strengths and Limitations

Location / Availability: Free, Purchase, or Citation

Literacy – Spanning the US: Peoria IL :: Huntington WV :: Elgin IL :: Frederick MD

“I thought, I have to get my GED and then everything will fall into place,” Archie said.

Volunteers are the heart of Tri-State Literacy Council

Herald Dispatch: 6.08.2015

Tri-State Literacy Council trains 30-60 volunteer tutors each year. All our tutors are amazing.

Vivian Atkinson, a tutor with TSLC for more than 10 years, tutored a lady for three years until she attained her high school equivalency diploma. Andrea Lupson, a tutor with TSLC for almost two years, tutored a gentleman whose first language was not English. Not only did she cultivate his interests in the United States, she helped him improve his workplace and language skills, so he could obtain a job in Huntington.

Many of our volunteers work with learners for greater periods of time than the requested one hour per week. Some TSLC tutors take on tutoring more than one learner, putting in additional hours of planning and instructional time. Skip Flynn, Linda Board, Donna Wheeler, and many others, work or have worked with multiple learners each week.

Still more of our tutors, who originally planned on volunteering with TSLC for only nine months to a year, have stayed with our organization. Dr. Evelyn Pupplo-Cody has been with TSLC for more than 20 years. We have a host of tutors who have volunteered for five years or more, and many more tutor longer than the one year they first signed up for. Our tutors show up. TSLC tutors volunteer for many other projects. They show up at Marcum Terrace for Summers on the Terrace. They show up for family literacy events at CCPL main and other branch libraries. They show up for Tutor Advisory Board meetings to help support one another and to find ways to make tutoring more successful for tutors and learners.  READ MORE !

The Literacy Connection honored tutors and learners at the annual Tutor/Learner Recognition

Daily Herald: 6.10.2015 by Carolyn Chadwell

The Literacy Connection's annual Tutor/Learner Recognition was held Thursday, June 4, at the Gail Borden Public Library in downtown Elgin.

A morning program took place from 9:30 to 11:30 a.m. and an evening program took place from 6:30 to 8:30 p.m.

More than 100 tutors and their learners attended the event to celebrate their outstanding efforts during the past year.

Certificates were awarded to tutors and learners who reached milestones in the following categories: Tutors with 5- and 10-years of service; Learners with 5, 10 and 15 years of attendance; Learners with over 50, 75 or 100 hours of attendance; and Tutors with over 50, 75, 100 and 125 hours of service.

Administrative and testing volunteers also were acknowledged and awarded certificates.

There were two guest speakers: Carina Morales in the morning program and Eustacio Baldazo in the evening program.

Both speakers delivered inspirational stories of their personal and professional achievements since beginning the adult literacy program with The Literacy Connection.  READ MORE !

Literacy Council volunteer still going strong after 40 years

Frederick News Post: 6.13.2015 by Laura Dukes

Caroline Gaver has spent more than half of her life with the Literacy Council of Frederick County.

The now 68-year-old owned a dairy farm with her husband, Joel, when she noticed some of their employees did not know how to read. She saw something in the newspaper about the Literacy Council looking for volunteer tutors, and it made her curious about how an adult would learn to read.

That was 40 years ago, and she’s been a volunteer with the council ever since.

The Libertytown resident said they taught, and still teaches, volunteers to tutor using the Laubach method. This is a multi-sensory phonics-based approach with charts and keywords, Gaver said. The keywords, such as “bird,” are meant to teach sounds of language.

When Gaver started volunteering with the council, the majority of the students she saw were American-born English speakers who were almost completely illiterate. They started learning at beginner levels, learning sounds and names of letters.

These students usually had received some schooling, but many had dropped out early, Gaver said. This was often because they had to work to help support their families.

“That was typical of the middle of the last century,” she said.  READ MORE !

2015 KIDS COUNT Data Book : : Annie E Casey Foundation

2015 KIDS COUNT Data Book

1.7 Million More Children Live in Low-Income Working Families Today Than in Midst of Great Recession

Annie E. Casey Foundation: 7.21.2015

About 1.7 million more children live in low-income working families today than during the Great Recession, according to the newly released 2015 KIDS COUNT Data Book from the Annie. E. Casey Foundation. In 2013, one in four children, 18.7 million, lived in a low-income working family in the United States. Nearly a third of children are living in families where no parent has full-time employment. And even when parents are working full time, wages and benefits are often not sufficient to adequately support a family

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National and State Rankings for 2015 Data Book

For the first time in a nearly a decade, a non-New England state ranks number one for overall child well-being. Minnesota holds the top spot, followed by New Hampshire, Massachusetts, Iowa, and Vermont. Arizona, Nevada, Louisiana, New Mexico and Mississippi rank lowest. Other state highlights:

■While three New England states rank within the top five for overall well-being among the 50 states, the top five states in the area of economic well-being are in the heartland and Plain States regions — North Dakota, Wyoming, Nebraska, Iowa and Minnesota.

■The biggest improvements in overall rankings compared to last year’s Data Book are seen in Alaska, Minnesota, Wyoming, South Carolina and Missouri. The biggest drops in overall rankings are seen in West Virginia, Indiana, Rhode Island, Virginia, Arkansas and Vermont.

■Southeast, Southwest and Appalachian states have the lowest income and are at the bottom of the overall rankings. With the exception of California, the 15 lowest-ranked states were in these regions.

Poverty is Persistent in Many Neighborhoods

Despite being several years into the economic recovery, one in five children remains stranded in poverty.

■Since 2008, the number of children living in poverty has risen by almost 3 million, from 13.2 million to 16.1 million today.

■At a rate of 22% in 2013, the rate of child poverty is still several percentage points higher than before the recession, when it was 18%.

=The number of children living in high-poverty neighborhoods – where poverty rates are more than 30% — is the highest since 1990:

■Today, one in seven children — 14% — live in high-poverty communities.

■More than two million more children live in areas of concentrated poverty today than in 2006-2010.

Recovery Sidesteps Children of Color

Race is one of the strongest factors influencing a child’s economic stability. Data show the economic recovery of the past several years has bypassed many children of color. Rates of unemployment at the close of 2014 were in single digits for all races except African Americans. African Americans were also the only group for whom unemployment remains higher than before the recession.

■African-American children are twice as likely as the average child to live in high-poverty neighborhoods and to live in single-parent families.

■American Indian children are twice as likely to lack health insurance coverage.

■Latino children are the most likely to live with a household head who lacks a high school diploma.

“The national averages belie the stark reality that millions of children, particularly African Americans, Latinos, and American Indians live on the precipice of poverty. Today, as the economy recovers, we see a widening gap between the living standards of many children of color and other kids,” said Laura Speer, associate director for policy reform and advocacy. “The good news is when we’ve invested in the right strategies and policies, we have made a difference for kids.  READ MORE !

Fixing healthcare in America begins with growing good readers : : Every Child Achieves Act

Key Takeaways of the

Every Child Achieves Act

David Griffith,

ASCD Public Policy

April 20, 2015

Fixing healthcare in America begins with growing good readers

The Hill: 7.09.2015 by David J. Bailey, MD, MBA

Reading is an essential building block of learning — but it may come as a surprise to many that reading proficiency is one of the strongest predictors of overall health through adulthood. Much of the conversation about literacy is focused on the economic impact of decreased worker productivity and lost income. In doctor’s offices and health systems across our country, we see first-hand the effect of reading challenges on our patients and its lifetime impact on health outcomes.  The relationship of literacy to health outcomes and expenditures is real, with a conservative annual estimated price tag of more than $106 billion.

In the United States today, thirty to forty percent of children are at risk for reading failure before they reach kindergarten. As a physician and the CEO of a children’s health system, I am encouraged by the bipartisan support for addressing reading failure for early learners contained within S.1177, the Every Child Achieves Act of 2015.

This pivotal legislation includes several important provisions for quality early childhood education that are the foundation of improving reading readiness, providing health education, and ensuring our children have a strong and healthy start in life. These programs are highly cost effective with an average return on investment for every dollar spent of seven to ten dollars in averted costs related to special education, grade retention, health care, welfare, and crime. Changing the cost equation in our healthcare system over the long-term begins with our children and starts at infancy.

Good readers have confidence that they are smart and are motivated to do their best each day in school, building a foundation for life-long self-esteem and productivity. Struggling readers often have bright minds that just learn differently, but they lose their confidence without proper support. Our experience with reading readiness through our Nemours BrightStart! program shows that when the needed supports are available starting in pre-kindergarten, an investment of as little as 12 hours can help struggling readers catch up with their peers.  READ MORE !

Literacy – Spanning the US: Evansville IN :: Waterville ME :: Berkeley CA

Central Maine: 6.07.2015 by Amy Calder

California Library Literacy Services

At the Bay Area Book Festival recently a panel of adult learners shared their journey of reading a book that impacted their lives. Michael, an adult learner, was inspired for the first time by a book: “It’s never too late to learn… that’s what I learned from this book. All people who are scared to read need to give themselves a chance.” Many thanks to the Berkeley Public Library for this!

The Struggle for Literacy, the Need for Booze, the Bay Area Book Festival

Pop Matters: 6.22.2015 by Diane Leach

I would buy no books.

As the Bay Area Rapid Transit escalator carried me upward, toward the first annual Bay Area Book Festival (6th and 7th, June), I repeated my new mantra. I would buy no books.

I would wander the streets lined with booksellers and listen to author panels.I would eavesdrop in ladies’ rooms and eat mediocre street truck fare. I would see An Evening With Judy Blume.

But I would buy no books.  Our small home is awash in books, any semblance of order long forgotten. The bookshelves need bookshelves.

Steeling myself, I began walking.

Five city streets were given over to booksellers and publishers, who were grouped by topic: Literary Lane, Radical Row, Writer’s Row, Eco Alley, and Mind and Body Blvd.  At Civic Center Park, the Lacuna, a circular installation of 50,000 free books, gradually came down as people made their selections.

The Festival offered free author panels and readings in venues around the city. As the San Francisco Bay Area is filled with writers, the difficulty lay in narrowing down who to see. Too often wonderful writers were scheduled simultaneously, forcing tough decisions. Michelle Tea or Maxine Hong Kingston? Ayelet Waldman and Michael Chabon or Jane Hirschfield? This speaks not to poor scheduling, but the wealth of Bay Area talent.

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Next, the Bay Area Literacy Panel. There, six adults described the hurdles each had only recently overcome to attain literacy. An East African woman held up a biography of Michael Jackson. Like the singer, she had abusive father who interfered with her education. Her voice breaking, she described being beaten, forced to work, and running away from home—at age seven. Now a mother herself, she told the audience her children’s lives would be better than hers. “I put them in school. I make them play.”  READ MORE !

Literacy:

a way out for at-risk youth

Jennifer Sweeney

Libraries Unlimited, [2012]

Library director says literacy can lessen prison numbers

Hammond Star: 7.09.2015 by Lauren Langlois

Promoting literacy would help reduce the prison population, the director of the Tangipahoa Parish Library System told the Amite Chamber of Commerce on Wednesday.

"The more people who can read, the fewer people we put behind bars," said Barry Bradford, director of TPLS.

Citing a study from Northeastern University, Bradford said that those who did not graduate from high school are 63 times more likely to end up in jail than college graduates.

He also pointed to the national statistics that say 60 percent of inmates and 85 percent of juveniles in the justice system are functionally illiterate.

Bradford said that while it may not be as expedient as building more jails to relieve cramped prisons, investing in early childhood literacy will be a long lasting solution to the country's huge prison population.

"Let's invest in [children]," he said.

Bradford said the library is helping to promote literacy in young children with its Baby and Me program, which invites parents/guardians to play and sing with their six- to 36-month-old babies.

This helps the young ones to learn through playing, while developing motor and socializing skills. It also shows that reading books can be fun, as well as important, he told the chamber members.  READ MORE !

Ten Minutes a Day Could Change Everything.

Ten Minutes a Day Could Change Everything.  

SaveTheChildren 

A young boy asks his dad to read to him.

When he says no, what happens next spells out

why everyone should take time to read together.

Literacy – Spanning the US: NY NY :: Delaware Co PA :: Williamson Co TN

Among Stanley’s favorite experiences with the Literacy Council are graduation ceremonies held occasionally at the jail. Caps and gowns are brought into the class, and certificates are presented to high school equivalency graduates.