Hi again, Mark,

What about low literate adults whose first language is English?  How  
are increases in literacy related to their health?  Why I ask--in some  
cultures there has been measured a direct (causal) relationship between  
literacy in women and lower fertility, that is, fewer children and more  
of them survive to adulthood.

In this country, do you see any direct relationships such as this  
between literacy and health?  I am thinking of "health" in a public  
health manner--health outcomes which affect the whole community.  If  
there is not a direct relationship, is there a literacy variable that  
would plug into a regression equation, as one factor among several,  
that leads to socially desired outcomes?  --as: fewer children,  
healthier children, higher income, and so on.

Thanks very much.

Andrea



On Sep 18, 2007, at 9:41 AM, Kutner, Mark wrote:


> There is a close relationship between health and literacy, just as  

> there is a close relationship between literacy and income, which I  

> imagine does not surprise any of us.

>  

> I very much enjoyed your characterization of the relationship between  

> health and literacy as a "distinction without a difference."  To me  

> this distinction without a difference underscores the need to  

> incorporate health literacy-related materials within our adult  

> education and literacy programs, especially in ESL programs.  The NAAL  

> data really documents the challenges faced by adults whose first  

> language is not English.

>

> From: healthliteracy-bounces at nifl.gov  

> [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Andrea Wilder

> Sent: Monday, September 17, 2007 1:29 PM

> To: The Health and Literacy Discussion List

> Subject: [HealthLiteracy 1201] Re: (no subject)

>

> Hi Mark,

>

> first, I apologize for not ahvng at my fingertips more information  

> about the NAAL, but here goes:

>

> 1) is there a relationship between health and literacy?

> 2) If so, what is it?

>

> 3) What is the relationship between health literacy and literacy? (A  

> distinction without a difference?)

>

> Thanks.

>

> Andrea

>

>

> On Sep 17, 2007, at 12:05 PM, Kutner, Mark wrote:

>

>> 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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