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Health Literacy

  • Last modified date:
    20 November 2007

Health literacy is defined as the cognitive and social skills that determine the motivation and ability of individuals to gain access to understand and use information in ways that promote and maintain good health.

This means much more than transmitting information and developing skills to undertake basic tasks. By improving people’s access to and understanding of to health information and their capacity to use it effectively, improved health literacy is critical to empowerment.

What are we doing about health literacy?

Our main activities at present are:

  • the development of a strategic framework,
  • supporting a number of research priorities,
  • the development of health literacy networks,
  • and Skilled for health – our health literacy delivery programme.

Strategic Framework

This area of work aims to frame the health literacy programme and detail how this will develop. This includes how the Skilled for Health programme and health literacy research contributes to the framework. An Expert Symposium on the framework took place in October 2007 to inform this development and it is intended to take this to a wider audience to build consensus on the framework.

Research and development

We are developing work on the following:

  • Development and participation in a national survey of health literacy, proposals include taking part in an EU programme and/or developing our own survey.
  • The definition and development of an economic case for health literacy.
  • An update on the health literacy literature review produced by the NSMC
  • Support for networks on health literacy
  • Partners include London South Bank University and the National Social Marketing Centre.

Skilled for Health

In 2003 Hazel Blears the Public Health Minister and Ivan Lewis the Skills Minister, launched “Skilled for Health”, a joint DfES/DH project with a Non-Governmental Organisation (NGO) partner ContinYou. This was a sub-project of the DfES Adult Basic Skills Strategy “Skills for Life”.

Impact of health literacy on health

Evidence from the first published study of functional health literacy in America, found:

  • 42 per cent of patients could not understand directions for taking medication on an empty stomach
  • 26 per cent were unable to understand information on an appointment slip
  • 43 per cent did not understand the rights and responsibilities section of a Medical application 
  • 60 per cent did not understand a standard informed consent

A 2-year follow-up study found patients with inadequate literacy were nearly twice as likely to have been hospitalised during the previous year (31.5 per cent vs. 14.9 per cent) (Baker et al 1998)

Other US research has indicated that diabetes patients with low literacy experience poorer health outcomes and are less able to manage their condition effectively. Blood sugar levels were higher in patients with lower literacy and rates of diabetic retinopathy were increased in this group (Schillinger et al 2002)..

As an example, recent research on 33-year-old adults in England has shown a strong correlation between indicators of poor health or unhealthy lifestyles and a poor experience of secondary education. When comparing those who were disengaged at school and had no GCSE qualifications and those who did, the odds of:

  • smoking are 4.7 times higher for women and 3.5 times higher for men
  • drinking heavily are 1.5 times higher
  • taking exercise less than once a week are 1.5 times higher
  • having depression are 2.4 times higher for women and 2 times higher for men
  • having back pain are 1.3 times higher in men
  • having migraines are 1.3 times higher in women.

More recently further UK research has indicated that low health literacy has been associated with poorer health outcomes where each incremental increase towards higher health literacy is associated with a greater likelihood of eating at least 5 portions of fruit and vegetables a day, exercising and being a non smoker (von Wagner et al 2007).

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