National Academies Press: OpenBook
« Previous: 1 Introduction
Suggested Citation:"2 Keynote Address." Institute of Medicine. 2011. Improving Health Literacy Within a State: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13185.
×

2

Keynote Address

OPENING REMARKS AND INTRODUCTION OF KEYNOTE SPEAKER

Alfred E. Osborne, Jr., Ph.D., M.B.A., M.A. Anderson School of Management

Osborne emphasized the importance of health literacy and noted that the U.S. Department of Health and Human Services (HHS) has made improving the nation’s health literacy a national priority. In his view, having the Anderson School of Management cosponsor a workshop on health literacy with the Institute of Medicine (IOM) is consistent with the school’s mission of enhancing the administrative skills of leaders within organizations that are addressing the needs of underserved communities. For example, the school’s Health Care Institute (HCI) has experience training Head Start Program leadership, staff, and participants. HCI also has a relationship with the Health Resources and Services Administration (HRSA) in its work with community health centers. Osborne welcomed roundtable members, speakers, and the audience to the UCLA campus and introduced the keynote speaker, Eugene Washington.

Suggested Citation:"2 Keynote Address." Institute of Medicine. 2011. Improving Health Literacy Within a State: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13185.
×

OVERVIEW OF THE ROLE OF THE UNIVERSITY IN IMPROVING HEALTH LITERACY STATEWIDE

Eugene Washington, M.D., M.Sc. UCLA Health Sciences and David Geffen School of Medicine at UCLA

Washington addressed four questions pertaining to health literacy in his presentation: Why is health literacy important? Who must understand its importance? How can its importance best be conveyed? What is the role of the academic community in addressing the needs of health literacy? Washington pointed out that the focus of the workshop is state-based approaches to health literacy, but he emphasized the global nature of the problem of low health literacy. He suggested that what is learned from local and statewide efforts could be translated to affect care around the world.

The transitive property states that, “If a = b and b = c, then a = c.” This formula is used in philosophy, especially in the understanding of logic. Using the transitive property in the context of health literacy and quality health care means that if the quality of health care (a) depends on effective patient provider communication (b) and effective provider communication depends on understanding the health literacy level of the patient (c), then the quality of care depends on understanding the patient’s health literacy level. In short, the quality of care depends on both the patient’s level of literacy and the effectiveness of provider communication. This transitive property can also be applied in the context of population health. The ability to improve the overall health status of a population or a community depends on the effectiveness of communication with the entire community. And that, in turn, depends on understanding the health literacy level of the population.

The IOM report, Crossing the Quality Chasm, stated that health care should be safe, effective, patient centered, timely, efficient, and equitable (IOM, 2001). If care is patient centered, individuals leave their clinical encounter with the understanding that their specific needs have been met. Timely care means that necessary interventions are available and the processes of care are efficient. Washington observed that poor communication is often what leads to medication errors. A clinician may choose the wrong therapy for a patient because he or she did not understand what the patient was saying. Alternatively, a patient may not take medications appropriately because the clinician did not give specific instructions.

In early research that examined the elements of patient-provider communication and shared decision making, episodes of care were videotaped with the provider knowing that the encounter was being recorded. Patients and providers rated the encounters in terms of whether “part-

Suggested Citation:"2 Keynote Address." Institute of Medicine. 2011. Improving Health Literacy Within a State: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13185.
×

TABLE 2-1 Experience of Collaboration in Decision Making, Simulated Model


Shared Decision Making Positive Negative

Present True partnering 22% False partnering 38%
Absent Assumed partnering 21% Unwilling partnering 19%

SOURCE: Adapted from Saba et al., 2006.

nering” in care occurred. True shared decision making occurred only 22 percent of the time while simulated shared decision making occurred 38 percent of the time (Table 2-1).

When thinking about improving health literacy, Washington said, it is important to understand the perspectives of the various parties that listen to health literacy messages. The reaction to the message will depend on the role in which the recipient views him or herself. Yet the deliverer of the message often views the recipients as uniform. Various roles of the recipient are those of audience, customer, constituent, partner, and stakeholder (Table 2-2).

Those that need to be engaged to effectively understand and communicate the importance of health literacy include patients, providers, employers, payers, policy makers, communities and populations, community leaders, researchers, educators, and communicators and disseminators. When developing messages it is important to distinguish who is the primary audience, customer, constituent, partner, or stakeholder. It may also be necessary to think about whether particular groups are the primary, secondary, or tertiary audience.

There is value in partnering with the communications industry because of its great expertise in using media to communicate effectively, Washington said. This key group, which has not been given sufficient attention, should be viewed as a principal partner and a major stakeholder in both education and research efforts. Members of this group can also be involved in efforts to intervene and improve health status.

In terms of the academic community, health sciences centers, schools of education, and schools of communication have a major role to play in conveying the importance of health literacy and furthering health literacy practice. The academic community more broadly has a key role to play in teaching and expanding the relevant workforce and in advancing research methods and knowledge of what works.

Projections of health professional shortages in California made by HRSA can provide opportunities insofar as they represent positions for

Suggested Citation:"2 Keynote Address." Institute of Medicine. 2011. Improving Health Literacy Within a State: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13185.
×

TABLE 2-2 Groups Involved in Health Literacy: Definitions


Audience The group of spectators at a public event; listeners or viewers collectively, as in attendance at a theater or concert. A regular public that manifests interest, support, enthusiasm, or the like; a following
Constituent A person who authorizes another to act on his or her behalf, as a voter in a district represented by an elected official
Customer A person who purchases goods or services from another; buyer; patron
Partner A person who shares or is associated with another in some action or endeavor; sharer; associate. A player on the same side or team as another
Stakeholder A person or group not owning shares in an enterprise, but affected by, or having an interest in its operations, such as the employees, customers, and local community

SOURCE: Dictionary.com.

which individuals will have to be trained. Newly trained health personnel should be educated to understand the importance of health literacy and provide care that is linguistically appropriate, Washington said.

Educational institutions have played an important role in furthering the use of multidisciplinary, community-based, participatory research. Such research should include schools of business, engineering, education, and communication, along with the traditional disciplines in health sciences. Another area for involvement of the academic community relates to interventions to improve health literacy. Researchers in academic institutions are furthering the science of establishing what interventions are most effective. Interventions include communication strategies both at the individual level, and for populations at large. The development of methods, measurements, and standards are critical to understanding what works and to determine whether or not providers, institutions, organizations, and communities are providing care and messages that are at the appropriate health literacy level.

The educational enterprise must embrace the idea of a continuum of lifelong learning, not only for individuals and patients, but also for healthcare providers. Such an approach is needed in order to fully appreciate the dimensions of low health literacy and the opportunities to intervene and ensure high-quality health care. Low health literacy is not simply a local, state, or even a national problem. It is a global problem. The outcomes of forums such as the IOM workshop have broad implications with the potential for improving health worldwide, he concluded.

Suggested Citation:"2 Keynote Address." Institute of Medicine. 2011. Improving Health Literacy Within a State: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13185.
×
Page 3
Suggested Citation:"2 Keynote Address." Institute of Medicine. 2011. Improving Health Literacy Within a State: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13185.
×
Page 4
Suggested Citation:"2 Keynote Address." Institute of Medicine. 2011. Improving Health Literacy Within a State: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13185.
×
Page 5
Suggested Citation:"2 Keynote Address." Institute of Medicine. 2011. Improving Health Literacy Within a State: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13185.
×
Page 6
Next: 3 State-Based Models to Improve Health Literacy »
Improving Health Literacy Within a State: Workshop Summary Get This Book
×
 Improving Health Literacy Within a State: Workshop Summary
Buy Paperback | $39.00 Buy Ebook | $31.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. According to Health Literacy: A Prescription to End Confusion (IOM, 2004), nearly half of all American adults—90 million people—have inadequate health literacy to navigate the healthcare system.

To address issues raised in that report, the Institute of Medicine convened the Roundtable on Health Literacy, which brings together leaders from the federal government, foundations, health plans, associations, and private companies to discuss challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors. On November 30, 2010, the roundtable cosponsored a workshop with the University of California, Los Angeles (UCLA), Anderson School of Management in Los Angeles.

Improving Health Literacy Within a State serves as a summary of what occurred at the workshop. The workshop focused on understanding what works to improve health literacy across a state, including how various stakeholders have a role in improving health literacy. The focus of the workshop was on presentations and discussions that address (1) the clinical impacts of health literacy improvement approaches; (2) economic outcomes of health literacy implementation; and (3) how various stakeholders can affect health literacy.

READ FREE ONLINE

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!