[NIFL-HEALTH:4139] Re: "Health literacy" out "Clear Health Communication" in

From: Audrey Riffenburgh (ar@plainlanguageworks.com)
Date: Mon Sep 22 2003 - 15:58:24 EDT


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From: "Audrey Riffenburgh" <ar@plainlanguageworks.com>
To: Multiple recipients of list <nifl-health@literacy.nifl.gov>
Subject: [NIFL-HEALTH:4139] Re: "Health literacy" out "Clear Health Communication" in
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Greetings, Ian and other "listers":

I read your post about the term "clear health communication"  with
interest. I attended the Pfizer Health Literacy conference in DC last
week, too, and, personally, I was glad to see the new term in use. My
colleagues in the Clear Language Group and I have been working with
Pfizer on its health literacy initiative since its inception 6 or 7
years ago. We have talked quite a bit with Pfizer about our concerns
that the focus on people with low literacy skills was too narrow. I am
glad to see the new term coming into wider use.

I came into my health literacy work from the adult literacy field (I've
worked at the local, state and national level). I am VERY aware of the
huge challenges these people face and I don't want to dilute the
attention given to them. At the same time, I felt that framing the
problem as mainly a "literacy" issue rather than a lack of plain
language usage by health care professionals was problematic. I always
felt that focusing on people with limited overall literacy skills put
the responsibility for lack of communication at their feet. It laid too
much blame on them, especially when we talked about how much low HEALTH
literacy costs the medical system. Instead we need to put more of the
responsibility for communication on to health care providers. I also
think that if we are talking to health care providers about 20% of US
adults, it's harder to get their attention. They can more easily dismiss
the information by saying, "I don't have any of those people in my
practice." Whereas framing the issue in a larger context can help those
providers understand the serious scope of the problem.

I think we must continue to speak out about the challenges people with
low overall literacy face, the impact of low literacy skills on their
health, etc.  I don't believe they will get lost in the transition. I
think widening the focus may even help them more than the current view.
I like reframing the issue in the new way because it helps health care
providers and people who develop print materials understand the
responsibility which is rightly theirs in the communication process. It'
s not just about people who struggle to read. It's about how difficult
it is for ALL of us to understand and use health information when it's
presented in such a way that the general public can't make sense of it.

I look forward to hearing others' perspectives on this issue.

Audrey Riffenburgh, M.A.
President, Riffenburgh & Associates
P.O. Box 6670, Albuquerque, NM  87197-6670
Phone: (505) 345-1107  Fax: (505) 345-1104
E-mail: ar@plainlanguageworks.com
Specialists in Plain Language & Health Literacy since 1994
=============================================
Principal & Founding Member, The Clear Language Group
www.clearlanguagegroup.com



----- Original Message -----
From: "Ian Bennett" <ibennett@mail.med.upenn.edu>
To: "Multiple recipients of list" <nifl-health@literacy.nifl.gov>
Sent: Monday, September 22, 2003 7:04 AM
Subject: [NIFL-HEALTH:4134] "Health literacy" out "Clear Health
Communication" in


> Hello Everyone,
>
> I was lucky enough to be able to participate in this year's Pfizer
Health
> Literacy Initiative annual meeting in Washington and had a few
thoughts
> that I thought might fit well in the discussion here. There were many
> interesting presentations and discussions that covered the progress,
> limitations, and possible future for work in health literacy. I was
really
> happy to hear people talk about the formation of collaborations
between the
> worlds of adult education and health for basic research and
intervention
> development/evaluation.
>
> One interesting point that I wanted to discuss further to help my own
> thoughts is the change of the name of the Pfizer program from "Health
> Literacy" to "Clear Health Communication." There has always been a lot
of
> confusion about what exactly anyone meant when they used the phrase
health
> literacy (one person might be thinking mostly literacy and another
> something about health system navigation skills). This name certainly
> clarifies the focus but I am interested in what it might mean for the
study
> of literacy and health.
>
> Clearly low literacy skill will continue to be a part in how clear
health
> communication can happen and maybe this is what many people thinking
about
> health literacy where really talking about all along. But, now that
the
> word literacy isn't in the title any longer does this pull the focus a
bit
> away from the obstacles faced by those who cannot read? If so, let's
not
> forget that most of the work out there on poor health status and
outcomes
> is related to literacy (or more precisely reading) not the more global
> concept of health literacy. We also are always referring to the NALS
which
> measured literacy not health literacy. What I mean to say is that
there
> isn't much that I am aware of that shows that someone with high
reading
> scores but would score low in the theoretical domains of health
literacy,
> will have more illness, spend more time in the hospital, or die
sooner,
> than someone with good reading skill and good health literacy. It may
be
> true but there is no evidence of it.
>
> There are some interesting areas in health communication that are
suddenly
> opened up by the use of the "clear health communication" phrase like
the
> data that there are health disparities (that is differences in quality
of
> care and health outcomes that follow the lines of race) in the kinds
of
> options and care that is offered to patients as well as actual health
> outcomes (Cooper-Patrick, Roter, and others). I have not heard those
> studies mentioned previously at the Pfizer conference but maybe it is
time
> to bring it in.
>
> To end this stream of consciousness I guess there are new
opportunities but
> also some new challenges to make sure that the literacy part is not
lost as
> we move forward as a group.
>
> Ian M. Bennett, M.D., Ph.D.
> Department of Family Practice and Community Medicine
> University of Pennsylvania
>
>



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