Literacy Assistance Center
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NYC Health Literacy Initiative

  • Health Literacy at the National Level
    • Low Health Literacy Linked to Higher Risk of Death and More Emergency Room Visits and Hospitalizations
      US Dept. of Health & Human Services Press Release, March 28, 2011. Agency for Healthcare Research and Quality, Rockville, MD.

      Why Health Literacy?

      According to the Institute of Medicine’s report Health Literacy: A Prescription to End Confusion, up to half of all Americans have trouble understanding and acting on health information. Limited health literacy impairs people’s ability to engage in healthy behaviors and to follow medical advice.

      People with low health literacy are more likely to suffer poor health, use the emergency room, and experience longer hospital stays. Low health literacy disproportionately affects the poor, the elderly, and members of minority and immigrant communities. When parents are poor, their children may not have necessary access to medical, vision, hearing,and dental careall of which correlate with school success.

      Definition: What is health literacy?
      By the numbers: Health literacy statistics

      Health Literacy Initiative Projects

      In response to the need for better health literacy, particularly among low-income and immigrant populations, the LAC established the NYC Health Literacy Initiative with the help of our advisory board. We provide professional development to help literacy instructors integrate health literacy skills in their curriculum, facilitate partnerships between literacy and healthcare organizations, develop programs such as Baby Basics NY to assist at-risk populations, offer assistance in effective communication to healthcare and social service organizations, and serve as liaison to connect healthcare and literacy organizations with public policymakers.

      Professional development

      Literacy practitioners are not, and should not be, expected to teach health content, such as recognizing the symptoms of a heart attack. They are, however, already expert in teaching the skills needed for health-related tasks: calculating time and medication dosages, reading labels and instructions, filling in forms, describing symptoms, and so on. Furthermore, the population served by adult education programs overlaps with the groups most at risk for poor health: undereducated, poor, minority, or immigrant adults.

      The LAC is therefore training instructors in a new paradigm of health literacy instruction that infuses health literacy skills into the adult literacy curriculum. Health literacy study circles, developed by a team lead by Dr. Rima Rudd of Harvard School of Public Health and the National Center for the Study of Adult Learning and Literacy, enable participating instructors to integrate health literacy skills in three critical areas:

    • Navigating the healthcare system, for example, reading signs and maps, asking the right questions of healthcare providers, filling out insurance forms
    • Managing chronic diseases, for example, following medical instructions, measuring and scheduling medications, avoiding situations or substances that exacerbate the condition
    • Participating in preventative activities, for example, exercising, eating healthy foods, managing stress

A preliminary evaluation (PDF, 984K)of the pilot HLI program shows the promise of health literacy study circles for learner outcomes. Participating students improved on a measure of health literacy skills, and their teachers reported that the health literacy lessons addressed communication and critical thinking skills.

The professional development framework and sample lesson plans from the first two sets of study circles are available on our health literacy resources page.

Literacy-health partnerships

Another facet of our Health Literacy Initiative has partnered some of the literacy programs that participated in the pilot health literacy study circles with a healthcare provider in their neighborhood. Activities such as tours of the healthcare facilities helped literacy instructors and students gain context for their work on health literacy skills. The healthcare organizations, for their part, gained insight into the needs of low-literate and immigrant populations and began to improve staff members’ ability to communicate with these populations.

To capture and share lessons learned from establishing these partnerships, the LAC developed Healthy Relationships: A Guide to Forming Partnerships between Health Care Providers and Adult Education Programs. (PDF, 96K) This guide offers insights into the challenges and rewards of literacy-healthcare partnerships and outlines strategies for successful partnerships.

The pilot partnerships were:

We are working with the NYC Health & Hospitals Corporation to establish additional partnerships.

Program development

Our Health Literacy Initiative is expanding with new programs that enable healthcare and social services organizations to more effectively serve populations with low literacy and English-language skillsgroups that are often at risk for poor health.

  • Baby Basics New York offers an opportunity for low-income women to improve their chances of a successful pregnancy.
  • The LAC/United Way Community Health Literacy Project enables social service workers and clinicians to communicate more effectively with women who have HIV/AIDS.

Communication assistance

The LAC engages in contract work to help healthcare organizations and other interested stakeholders to develop plain-language print materials. Clients have included the Medical and Health Research Association, the Center for Immigrant Health at the NYU School of Medicine, and the Community Service Society of New York.

One brochure we revised for CSSs Managed Care Consumer Assistance Program provides an example of appropriate patient/consumer information for vulnerable populations. See the text as MCCAP prepared it for more advanced audiences and as we reworked for low-literate and immigrant populations in before and after versions. MCCAP provided their content expertise and print designer. We provided our knowledge of the pitfalls that difficult text can represent for unskilled readers and of ways to avoid those pitfalls. The product is a perfect collaboration.

For information on the LAC’s plain language communication services, contact Interim Executive Director Jim Meier, 212.803.3302.

Policy liaison

In 2004, the LAC and the Mayor’s Office sponsored a series of three health literacy summits for literacy practitioners and healthcare providers designed to create a strategy for developing literacy-health partnerships. Presenters at these meetings included Rima Rudd, Sc.D., director of education programs at the Harvard School of Public Health; Emilio Carrillo, M.D., M.P.H., president and chief medical officer of New York-Presbyterian Community Health Plan and associate professor of clinical public health and medicine at the Weill Cornell Medical College; and Victoria Purcell-Gates, Ph.D., professor of teacher education at Michigan State University. Each summit also included presentations and discussions by local health and literacy practitioners

An Independent Evaluation

A Formative Evaluation of the LAC New York City Health Literacy Initiative by John Comings, Harvard Graduate School of Education and Elisabeth Robart, Teachers College, completed in 2007 found that it has a significant impact on both those who receive training and the ultimate beneficiaries who have limited literacy skills.

Health Literacy at the National Level

National Action Plan to Improve Health Literacy

Health Literacy Town Hall Meeting Notes

For More Information

For more information on the LAC’s Health Literacy Initiative, contact Winston Lawrence, Ed.D., Senior Professional Development Associate, at 212.803.3326.

For more information on health literacy, go to http://en.wikipedia.org/wiki/Health_literacy

Check our Calendar for upcoming workshops and events.