Health and Literacy: A Review of Medical and Public Health Literature

Volume 1: Chapter Five

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In Chapter Five, Rima Rudd, Barbara A. Moeykens and Tayla C. Colton share their examination of the medical and public health literature regarding links between health and literacy and identify trends in research and practice. The authors note the connection between educational attainment and health, as education may influence lifestyle behaviors, problem-solving abilities and values. In addition, the authors point out how literacy has been shown to be related to patients' ability to describe their own symptoms, which can in turn, influence the care that they receive. Further, literacy has been demonstrated to directly influence patients' access to information on their rights and health care, including instructions and understanding of preventative measures and risks involved in medical procedures. As Rudd and her colleagues point out, the development in recent years of measurement tools for assessing the content of materials, as well as adults' health literacy levels and their links to health outcomes, has drawn attention to the mismatch that often exists between patients' reading levels and the delivery of the information made available to them. Too often, research shows, the literacy demands of material encountered by patients exceed the literacy abilities of the readers. Such has been shown to be the case with informed-consent materials, package inserts and a variety of health education materials on topics including diabetes, prenatal care and cancer, among others.

The authors also reveal the relationships shown between literacy and health outcomes. Lower levels of literacy, they conclude, are clearly associated with poorer health, and low levels of health literacy have a measurable impact on numerous intermediate factors that influence health outcomes, including screening and early detection. The authors recommend strategies for improving communication with patients, including improved readability of materials, involvement of patients in designing more effective materials and education of health care providers on the needs of low-literacy populations. Moreover, as they point out, adult basic education programs can provide opportunities for working with lower literacy populations to develop and test strategies for improved patient communication. Rudd, Moeykens and Colton call for more research on the relationship between levels of health literacy and health outcomes, the intermediate factors that influence health outcomes, and health care costs. They stress the need for continued efforts to develop strategies to address the special needs of those with low health literacy. The authors close by describing some exemplary projects that illustrate the potential for effective collaboration between professionals in education and health in seeking to meet the needs of less literate populations.

 Chapter 6 

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The Annual Review was published in October 1999.
The ISBN is 0-787-94741-5
Price: $37

To order The Annual Review of Adult Learning and Literacy, click on to the Jossey-Bass Publishers web site
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