1. Lessons from the Intersection of Adult Literacy and Health Literacy
John Comings
Principal International Technical Advisor
Education Development Center
Newton, Massachusetts
USA

2. Percent of UK Adults (16+) by IALS Literacy Level (1994-1995)
Percent Score Range
Level %
Level %
Level %
Difficulty of Text and Difficulty of Task

3. Abilities at Each Level
Level 1: can locate a single piece of information
Level 2: can locate several pieces of information
Level 3: can locate several pieces of information and use the information to accomplish a task. For example, using a flight schedule to plan travel arrangements.
High probability of accomplishing task at or below your level and low probability of accomplishing tasks above your level

4. Literacy is…
Component skills, print skills (alphabetics and fluency) and meaning-making skills (vocabulary, background knowledge, and comprehension)
Practices in which adults employ all of the component skills to accomplish tasks (enjoyment, work, health, religion, politics, academic learning, etc.) with text (books, memos, pamphlets, notes, websites, etc.)

5. Meaning-making and Print Skills at IALS Literacy Level Cut Score

6. Reasons for Level Score
Level 1: Reading Disabled (print and meaning-making skills)
Physical, Mental, or Cognitive Barrier
Limited English Skills
Age
Level 2: Under Educated (fluency, vocabulary, and background knowledge)
Lack of Reading Practice
Level 3+: Sufficient (domain specific vocabulary and background knowledge)
Academically Successful

7. Same Comprehension Score but Different Reading Profiles (by grade equivalents)

8. IALS Document Literacy by Age (USA data corrected for education & disabilities)

9. What Have We Learned about the Age-related Decline in IALS Score
What Have We Learned about the Age-related Decline in IALS Score? (secondary school dropouts in the USA)
Most secondary school dropouts continue to improve their literacy skills into their thirties
After that, some, but not all, dropouts decline in skill each year
Both increases and declines in skills are related to the amount and variety of practices
Adult education program participation can lead to increases in both test scores and amount and variety of practices or to only one

10. A Comprehensive Health Literacy Approach (Disability Discrimination Act or Universal Design)
Level 3+:
Plain, Clear Language
Access to additional information
Level 2:
Simple Language (readability)
Reading Support, particularly access to definitions and background knowledge
Level 1:
Assistive Technology

11. Technology May Be the Answer
IALS level 1 and 2 adults are rapidly increasing their access to information and communications technology
Technology is rapidly becoming less expensive and easier to use
In the U.S., 80% of high school dropouts make some effort to improve the basic skills or acquire a secondary school credential

12. Adult Education System
System has a significant number of students in programs; students have been tested for literacy and math skills, and most students face health literacy barriers
Teachers know a lot about the population
Use of authentic content in the classroom leads to more literacy practices outside the classroom
Students rate health as one of the most important domains of authentic content.

13. Implications
Build a comprehensive set of technology tools that anyone can learn how to use to accomplish health literacy tasks
Form a partnership between public health and adult literacy programs that benefits both

14. Web Resources National Research and Development Centre
for adult literacy and numeracy
Skills for Life Support Programme