Obesity has reached epidemic proportions, with one out of three children and two out of three adults in the U.S. being overweight or obese. Being overweight is so common that we seldom notice it. And words such as “obesity” and “overweight” are so freighted with judgement and shame that physicians are loath to bring it up for fear of offending their patients. So why not create a game that helps broach the subject in a safe way? Continue reading
- Health literacy is a key determinant of health
- Health literacy means empowerment: the capacity to make choices and transform those choices into desired actions and outcomes. (World Bank)
- Efforts are highly leveraged in pregnancy and early parenting
- Mothers’ health literacy is an important factor in prevention of noncommunicable diseases that are now the leading causes of death in the US and globally.
Fathers also have a critical role to play in their children’s health literacy, and their lives as a whole. In the traditional view of a father as the “breadwinner”, the health of a child is clearly impacted by the ability of the father to generate enough income to cover the costs of adequate food and water, housing, supervision, etc. “These aspects of the children’s quality of life contribute to health outcomes (e.g., nutrition deficits, obesity, respiratory infections, injuries, etc.)” (Ball and Moselle, 2007, p.7). Ball and Moselle go on to point out that research tends to focus more on fathers’ relationship to these quality of life issues, rather than on their direct effect on child health. Yet if we use a more wholistic or ecological view of the family and health, it becomes clear that the environment that children are raised in can greatly influence their opportunities for healthy development.
Good health is more than being free from pain and illness. It also means being able to enjoy life, have fulfilling relationships, and engage in meaningful work. Children who have close relationships with their fathers are less likely to engage in substance abuse, and more likely to do well in school. And since higher levels of education are correlated with better health outcomes, this is one example of how a father has an impact on a child’s health literacy. And a father’s involvement in their children’s lives is self-reinforcing: the more they learn about being an effective parent and enjoy it, the more they will engage in that relationship (Ball and Moselle, 2007).
Our country needs to put policies into place that will allow all parents full access to:
- Meaningful work that pays a living wage, reducing stress in the household and providing time for parents to develop adequate parenting skills and quality relationships with their children
- World-class education designed to help every child succeed to their full potential
- Complete healthcare for all, to assure that each succeeding generation will
Ball, J., & Moselle, K. (2007). Fathers’ Contributions to Children’s Well-being. Ottawa, Ontario, Canada.
Smith, S. (2013). Top 4 Reasons to Promote Maternal Health Literacy. Center for Health Literacy Promotion Blog.
Health literacy is the ability of individuals to recognize the need for, obtain, process, critically evaluate and understand health information and services in order to make appropriate health decisions. More and more research is demonstrating that when patient materials are adjusted for their intended audience, overall patient outcomes are better.
In a recent discussion paper on “Integrating health literacy with health care performance measurements” (DeWalt & McNeill, 2013), the IOM delineates a number of situations where health literacy-targeted interventions work:
- Caregivers who received plain-language, pictogram-based instructions were less likely to make errors in liquid medication dosing, and more likely to use a standardized instrument for measuring and administration.
- Diabetics are more likely to show improved control over their diabetes.
- Patients receiving a revised pamphlet with lower grade level readability scored higher on a comprehension test.
In general, understandable educational materials, and good verbal communication strategies help improve care for patients with low health literacy levels.
DeWalt, D. A., & McNeill, J. (2013). Integrating Health Literacy with Health Care Performance Measurement. Washington, DC: Institute of Medicine.
Though published back in January, this infographic is still very relevant, especially after McDonalds, whose workers are on strike for better wages, set up a website entitled “Practical Money Skills for Life“, which assumes two minimum wage jobs per household and no clothing purchases. Among the items highlighted, people with incomes below the poverty line are less likely to get preventive care that will keep them healthier.
As we advocate for programs that lift health literacy rates, equal weight needs to be thrown behind efforts to raise the minimum wage and the basic standard of living for those facing the greatest economic challenges.
Much effort and research is going into training healthcare providers on how to use plain language and other tools to combat low health literacy rates across the country. Printed materials are being rewritten at a fifth grade level, and include pictures and other images that will help. Research shows that online information should be taking a similar approach (Agarwal, 2013). But that is only half of the provider-patient relationship. What can be done to prepare patients to take full advantage of each and every health appointment? In particular, elderly patients find our complex system particularly hard to navigate. As one nurse succinctly reported, seniors are forced to rely completely on their physician. Yet many of her elderly patients report that:
- do not understand their doctor’s explanation of their medical condition, course of treatment, or medications;
- have hearing problems or other physical limitations; and
- have mental limitations that restrict their ability to understand complex medical information in a hurried fifteen-minute appointment (Gynn, 2013).
And as mentioned in a previous post, doctors are authority figures, whom even highly educated people are reluctant to ask challenging questions of (Chen, 2012). How can advocates for health literacy help seniors overcome these challenges and get their questions answered?
While browsing Twitter this morning, I discovered a tweet by Fran London (@notimetoteach) linking to a “course to train Meals on Wheels volunteers to become health literacy coaches”. For some elderly Americans, the person delivering Meals on Wheels may be the only human contact they have on a given day. If these drivers are trained to ask “Good Questions for Good Health”, as the training is titled, perhaps they can help prepare seniors to more fully participate in their next doctor appointment. This is the kind of out-of-the-box thinking needed, and the Center for Health and Risk Communication (CHRC) at the University of Georgia received a two-year, $970,039 federal stimulus grant in 2009 to create and study such a program (“UGA gets stimulus for elderly health project”, 2009).
Looking closer at this online course, the first page shows a broken image link. Links to many of their materials (flyers, presentations, etc.) are broken as well. If the CHRC wants others to consider replicating this excellent idea, a little better attention needs to be paid to maintaining their website. Such materials could be recreated, but why re-invent the wheel? Librarians are dedicated to the preservation of knowledge, and some academic libraries are beginning to see their role as moving to curators of data (Heidorn, 2011). Such data as this should not be lost to neglect.
Agarwal, N., Hansberry, D. R., Sabourin, V., Tomei, K. L., & Prestigiacomo, C. J. (2013). A comparative analysis of the quality of patient education materials from medical specialties. JAMA Internal Medicine, 1-2. doi: 10.1001/jamainternmed.2013.6060
Chen, P. W., MD. (2012). Afraid to Speak Up at the Doctor’s Office, New York Times.
Gynn, M. (2013). Health literacy for seniors. Florida Nurse, 61(1), 18-18.
Heidorn, P. B. (2011). The Emerging Role of Libraries in Data Curation and E-science. Journal of Library Administration, 51(7/8), 662-672. doi: 10.1080/01930826.2011.601269
UGA gets stimulus for elderly health project. (2013). Atlanta Business Chronicle.