Great point Andres - I think this is an excellent way to get to the
question that I have had regarding the measurement of health literacy
versus general literacy. I fully agree that contextual literacy is a
powerful component of navigating a "context" and that health literacy is
an example of contextual literacy. What I wonder about is simply whether
we have ever come up with a measure of health literacy skill that is
distinguishable from general literacy. I am not even sure how you would
do it actually and I'm not sure we want to. I know I am personally more
interested in how general literacy relates to health through direct and
indirect ways but I would be interested to hear anyone's thoughts about
why it would be important to have a measure of health literacy that
covered a distinct domain form the general case.
 
I wonder if Dr. Kutner has more to say on the subject?
 
Thanks,
 
Ian Bennett
 
-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Muro, Andres
Sent: Tuesday, September 18, 2007 11:50 AM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 1216] Re: (no subject)



Here is a little anecdote that I always share when I do health literacy
workshops. 

 

I often travel to DC with colleagues to do workshops, attend
conferences, etc. Most of my colleagues have post graduate degrees. In
other words, we are on top of the food chain when it comes to
educational achievement. Upon descending from the plane we head to the
subway station were I always perform my "anthropological" observation of
contextual literacy practices. Many of my colleagues go into a panic
when they have to interact with the ticket purchasing and dispensing
machine. They don't want to stand out. They don't want to hold the line
and they don't want to be left behind. In fact, it is common for people
traveling alone to get the much more expensive and inconvenient taxis to
avoid the "unfamiliar" literacy encounter. 

 

Fortunately, subway stations have a person that helps travelers interact
with these machines and explain maps and routes. In fact, these helpers
prefer to give oral directions to passengers rather than just refer them
to the written instructions. See, while I doubt that any of them studied
anthropology, they have figured out that we are still basically an oral
society when it comes to getting directions. Even the most literate
people prefer oral instructions when it comes to encounters with new
forms of literacy. Once they master the context, then they perform fine
within the print realm.   

 

We don't have to go to DC to experience this. Airplane tickets are now
dispensed by machines. Most grocery stores have electronic cash
registers. While most of us are proficient with these and realize that
they require basic literacy skills to operate, we can probably remember
our first encounters with this type of technology. Businesses, like
subway helpers know that we are still an oral society and always have a
person ready to verbally assist shoppers navigate these literacy
environments. Unfortunately, the much more sophisticated medical
establishment is catching on a little too late. At Walmart the airport
and the subway station, if you hesitate with the literacy task, an aid
shows up to assist you. Or, you have the option to go through the human
cash register. 

 

If we, highly educated people have difficulty getting a subway ticket,
and reading a subway map, you can imagine what a less educated person
must feel when they have to navigate through insurance documents,
patient intake forms, medication information, etc. 

 

Andres


  _____  


From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Barbara Duffy
Sent: Monday, September 17, 2007 7:36 PM
To: 'The Health and Literacy Discussion List'
Subject: [HealthLiteracy 1206] Re: (no subject)

 

I study health literacy and teach it  --- but I never personally felt
what it must be like to be 'illiterate' until yesterday when I tried to
read a computer manual. I can only assume the parallels with health
literacy must be similar. Way too many assumptions were made by the
authors of the computer manual for it to have much meaning for me....
And like much of the written materials we give to our patients to 'go
home and read - it explains everything'  there was no one I could ask
questions of - no one I felt had the time or patience for my stupid
inquiries, so I just muddle through and hope for the best.

 

Literacy issues are not confined to health care --- I have a feeling it
is epidemic and contagious. English may be but one language that we
speak with many, very foreign words.

 

Barbara Duffy

 


  _____  


From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Kutner, Mark
Sent: Monday, September 17, 2007 12:06 PM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 1198] (no subject)

 

Good morning all.  Cynthia Baur and I are very much looking forward to
answering any questions or issues that you might have related to the
health literacy component and report of the National Assessment of Adult
Literacy (NAAL).  Just as way of introduction, from 1999 through last
December I was the project director for the design, analysis, and
reporting component of NAAL.  In that role, I worked with Cynthia in
developing the health literacy component of NAAL.  The health literacy
items also had to be prose, document, and quantitative items so that
they could also be placed on the NAAL scale.  The health literacy items
were field tested before being included on the national study.  As we
discuss the health literacy component, it is important to remember that
the NAAL was administered in the homes of individuals, not in a doctor's
office or emergency room.

 

In case folks are shy, I want to pose a couple of questions to all of
you: 

 

1. As an individual who has been involved in adult literacy and
assessment for almost 20 years, I am curious to hear you perspectives
about the difference between measuring literacy and health literacy,
especially when the definition of health literacy (which we used from
HHS) does not indicate any prior substantive knowledge of health-related
issues (such as I take aspirin for headaches).  

 

2. Also, NAAL highlights the challenges of improving health literacy for
adults whose first language is not English.  What evidence do we have
about successful approaches to ensure that the health literacy for these
adults improves?

 

 

As we begin these discussions, I want to clearly acknowledge that there
would never have been a health literacy component of NAAL if it was not
for the hard work, perseverance,  stubbornness of Cynthia Baur. For me,
working with Cynthia on the health literacy component has been a real
joy.  The field is quite fortunate to be able to benefit from her
leadership!.

 



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