[NIFL-HEALTH:4151] "Health literacy" out "Clear Health Communication" in

From: Ian Bennett (ibennett@mail.med.upenn.edu)
Date: Tue Sep 23 2003 - 18:22:26 EDT


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From: Ian Bennett <ibennett@mail.med.upenn.edu>
To: Multiple recipients of list <nifl-health@literacy.nifl.gov>
Subject: [NIFL-HEALTH:4151] "Health literacy" out "Clear Health Communication" in
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Hiya Audrey,
Points well taken.
I do think we should be clear though that I am not aware of any evidence 
that an adult with good reading skills (as measured by literacy instruments 
including the REALM and TOFHLA) but have some difficulties with issues in 
the health literacy domains have negative health outcomes or cost the 
health system anything (maybe it does but we just don't have any data on 
this). When we talk about the data that health literacy and health outcomes 
are linked we are actually talking about literacy and health outcomes.
That is not to say that we should get doctors to speak more clearly, we 
should, and it will benefit everyone.
Ian

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



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