Health Literacy

“Communities – adult basic education centers, hospitals and health education programs, individual physicians and regional governments – are all wrestling with problems caused by low health literacy, but the formation of solutions remains a missing gap. The Sisters of Charity Foundation of Cleveland is responding with a unique undertaking that creates broad support for organizations addressing the health literacy issue, and attempts to do it in a way that ultimately reduces disparities in health.”

– Andrew Pleasant, Ph.D.
Professor, Rutgers University

Health literacy encompasses an individual’s ability to find, understand, evaluate, and use health information, to engage the services needed to make appropriate health decisions and navigate the health care system. More than just reading, for example, health literacy addresses the capacity to comprehend prescriptions, appointment slips, hospital admission policies, health insurance and financial eligibility information. Health literacy also focuses on how those abilities influence individual health care decision-making.

Community organizations and literacy coalitions in greater Cleveland are addressing the area’s low rates of basic literacy:

• 2004 report prepared for The Greater Cleveland Literacy Collaborative revealed that: “seven out of 10 in Cleveland lack the minimum literacy skills needed to effectively function in today’s society (five of 10 in Cuyahoga County)”.
• “In 2000, about nine percent of youth ages 16-19 in Cuyahoga County, and 17% of youth ages 16-19 in Cleveland, were neither employed nor in school,” according to a 2003 study by the Center for Community Solutions and United Way of Greater Cleveland.

For too many area residents, reading a bus schedule, understanding work benefits, or calculating the cost of menu items are anything but routine tasks. Low health literacy has a myriad of consequences to both patients and the health care system, including poor health outcomes, medication errors, preventable emergency room visits and hospitalizations.

Nearly half of all American adults – 90 million people – have difficulty understanding and acting upon health information. Poor health literacy costs the nation as much as $58 billion each year and affects every socioeconomic and ethnic group.

Almost half (47%) of adults in the U.S. read below an 8th grade level. When statistical adjustments are made for education and other socio-demographic co-variables, a person’s literacy level is the strongest factor impacting health knowledge and disease management skills. In fact, health literacy is a better predictor of one’s health status than age, income, employment, ethnicity, or education level.

The Health Literacy Initiative

The Foundation has developed a Health Literacy Initiative that envisions an integrated approach to literacy and health in Cuyahoga County in which multiple stakeholders – patients, health care providers and insurers, schools, libraries, media, the business community, government agencies and other community organizations – play a role.

The Foundation seeks to build support for a community-wide effort to advance health literacy and link with various efforts sprouting throughout the Midwest and nationally. Our objectives are:

• To increase the health literacy and capacity of individuals and providers to reduce health disparities, and
• To enhance the capacity of organizations to implement or adapt effective programs within the field of health literacy.

The Health Literacy Initiative began in June 2007 with the release of an RFP and an Educational Forum & Pre-Application Workshop showcasing some of America’s “best practice” programs. The pioneering program was shaped with input from regional and national experts, including Rutgers University Associate Professor Andrew Pleasant, Ph.D.

Initial grantees involved in planning and demonstration efforts were announced in November 2007. In recognition of the importance of health literacy to the development of healthy communities, The Cleveland Foundation has joined with the Sisters of Charity Foundation to act as a co-funder of the Health Literacy initiative.

With the initial group of grantees, in 2008 a variety of strategies will be tested with the goal of:

• encouraging better health decisions and healthy behaviors,
• promoting health literacy education and training for health professionals, and
• enhancing communication between consumers and care providers.

For More Information

The Health Literacy Wiki is sponsored by the Adult Literacy Education Wiki and is moderated by Julie McKinney, the Health Literacy topic area leader. Ms. McKinney may be reached at jmckinney@worlded.org.