I am sympathetic, but no, this is not culture shock.  I have cried in a  
hospital waiting room in order to get attention. I have also wandered  
the halls of hospitals wondering where the elevators were, restrooms,  
entrances/exits even.  I often "test out" health buildings to see how  
they guide a person from space to space, architecturally.  I play this  
game in other buildings, too--the public library, the supermarket.

I have long term tenants in my home, and I have designed my kitchen so  
ANYONE from ANYWHERE who knows ANYTHING about cooking  can find their  
way around and make a meal for themselves.  Kitchen shelves and pantry  
are zoned for different guests.  I watch how people move in constructed  
spaces, all the time, everywhere.  This is just observation skill.

I also listen to language--"consumers" of health care?  Grotesque.  How  
about "users?"  Last summer, while lying on a hospital bed i had a  
conversation with a nurse about her use of the word "consumer."  I  
don't "eat" anything, and I usually don't have much of a choice,  
either.  We should use language that reflects what is ACTUALLY GOING  
ON, rather than mush words like "consumer."  In a hospital, lying on a  
hospital bed, I am a patient, and it is the doctor or nurse who usually  
has the power--usually, because I could get up and leave.

Sorry, Nicola, if I am rude and cotnradictory, I get carried away by  
this topic--thanks for your positive remarks.

Of course health care should be a right, it is now a commodity.

Andrea


On Sep 19, 2007, at 10:38 AM, Davies, Nicola wrote:


> I love both of these examples, but this seems like more of an example  

> of 'culture shock', rather than health literacy. Let's all assume that  

> universal health care is a basic right (heaven forfend!). This adds a  

> new slant because it makes the elimination of systemic abuse of people  

> with lower literacy a completely different issue to techno-culture  

> shock.

> I know this detracts from the original discussion, but with all the  

> talk about the difference between literacy/health literacy, and  

> differences (or lack there of), we need to keep in mind that the right  

> of a person to have access to a doctor, and health and wellness  

> information is very different to the right to 'understand' all the  

> functions and extras of a big screen TV (understanding technology),  

> knowing how to catch a bus in another country (culture shock, Speaking  

> Other Languages). 

> Once we look at healthcare outside of the current systems of  

> bureaucracy, we can then see where the communication breakdowns  

> (betwen patient and healthcare worker) are, and where healthy  

> behaviours are prevented.

>  

>  

> -----Original Message-----

> From: healthliteracy-bounces at nifl.gov  

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

> Sent: Tuesday, September 18, 2007 7:51 PM

> To: The Health and Literacy Discussion List

> Subject: [HealthLiteracy 1227] Re: (no subject)

>

> Andres--

>

> A 100% fabulous example. Boston has gone the way of DC, still haven't  

> really figured out the system, and I always want to cry in  

> frustration. I can envision the meltdown of people whose language  

> isn't English when confronting our health institutions. Cambridge  

> hospital has translators available in several languages, fortunately..  

> However, the buildings themselves are an additional puzzle.

>

> Andrea

>

> On Sep 18, 2007, at 11:50 AM, Muro, Andres wrote:

>

>> 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!.

>>

>> ----------------------------------------------------

>> National Institute for Literacy

>> Health and Literacy mailing list

>> HealthLiteracy at nifl.gov

>> To unsubscribe or change your subscription settings, please go to  

>> http://www.nifl.gov/mailman/listinfo/healthliteracy

>> Email delivered to  

>> andreawilder at comcast.net---------------------------------------------- 

>> ------

> National Institute for Literacy

> Health and Literacy mailing list

> HealthLiteracy at nifl.gov

> To unsubscribe or change your subscription settings, please go to  

> http://www.nifl.gov/mailman/listinfo/healthliteracy

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