Measures of Health Literacy Workshop Summary (2009) / Chapter Skim
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4 Population-Based Approaches to Assessing Health Literacy
4 Population-Based Approaches to Assessing Health Literacy
Pages 61-72
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From page 61... ...
The objectives of the DAHL are as follows: • To impute limited health literacy from sociodemographic indica tors; and • To estimate the association of imputed limited health literacy with indicators of health status and compare findings with those from a measured indicator of limited health literacy (Short Test of Func tional Health Literacy in Adults, or S-TOFHLA)
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From page 62... ...
The potential gains of a demographic assessment could be substantial. The derived health literacy measures would be applicable to nationally representative survey data such as those obtained in the National Health Interview Survey (NHIS)
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From page 63... ...
Data from the Prudential Survey have been the source for a number of published studies evaluating the association between inadequate health literacy and health status. Data from the Prudential Survey was used to estimate the linear statistical relationship between the measured S-TOFHLA health literacy score and the four selected sociodemographic indicators (age, highest educational achievement, sex, and race/ethnicity)
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From page 64... ...
For difficulty with ADL, there is a consistently large association with inadequate literacy. Applying the DAHL and comparing the association of limited health literacy with health status outcomes from HRS found similar results, as shown in Table 4-2.
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Conclusion Results of this analysis support use of the DAHL as a proxy for identifying subgroups with limited literacy in nationally representative surveys. The four determinants of the DAHL appear to capture the important variation in health literacy as far as its impact on health status is concerned.
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From page 66... ...
served as an impetus for developing a population-level assessment of health literacy. The project identified specific Census tracts in the Los Angeles area where the quality of diabetes care was particularly low, and then asked what factors might explain the pattern of performance.
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Because NAAL oversampled populations in six states, the project built six predictive models with those larger populations to determine if the model performed differently on those different states.
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From page 68... ...
SOURCE: Lurie, 2009. Census tract ine 4-2, fixed image and 40 percent of people have basic Figur Missouri, between 25 or below basic literacy.
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From page 69... ...
Model and single variable estimates p different area level estimates PoPULATIon-BASeD APPRoACHeS To ASSeSSInG HeALTH LITeRACY d single variable estimates produce ifferent area level estimates Figure 4-3, fixed image FIguRE 4-3 Model and single variable estimates produce different area-level estimates. SOURCE: Lurie, 2009.
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From page 70... ...
Is there a point at which the percentage of community members with low health literacy is large enough that it has a negative effect on health outcomes? Or, conversely, is there a protective effect if a certain percentage of the community has adequate health literacy?
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From page 71... ...
She has very good health outcomes, however, in part because of her broad array of social capital supports. Incorporating social capital into the frameworks might enable one to determine whether the outcomes for those with low health literacy and high social capital are different from those with low health literacy and low social capital.
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From page 72... ...
For example, the National Health Plan Collaborative has data on Los Angeles, where Hispanic/Latino enrollees identified low quality of care for diabetes. The first idea for intervention was to send a letter with low-literacy levels of information in Spanish and English to thousands of members who had diabetes and Spanish surnames.
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