1. US Public Policy on Health Literacy Amber Burtis Midwest Chapter MLA Madison, Wisconsin September 26, 2010

2. Overview Background History of public policy related to health literacy “The National Action Plan to Improve Health Literacy” Implications for libraries

3. Public Policy The laws, regulations, courses of action, & funding priorities given to a specific topic by a governmental entity or its representatives (Evans, 2008). Both action & inaction

4. Quick Background “The degree to which individuals have the capacity to obtain, process, & understand basic health information & services needed to make appropriate health decisions” (IOM, 2004). ▫ Finding/evaluating health information ▫ Navigating health care system ▫ Poorer health outcomes & higher medical costs

5. History of Concept First mentioned in a paper titled “Health Education as Social Policy” which discussed the need for policy solutions to increase health literacy (Simonds, 1974). Earliest study linking literacy & health outcomes was the article “Literacy & Health Status in Developing Countries” (Grosse & Auffrey, 1989).

6. National Literacy Act (1991) Important moment in history of health literacy policy Goal was “to enhance the literacy and basic skills of adults…necessary to function effectively and achieve the greatest possible opportunity in their work and in their lives” (National Literacy Act, 1991).

7. National Adult Literacy Survey (1993) Came out of the National Literacy Act First study to identify the severity of illiteracy in the US (data available 1994) 1990s time of increased research & assessment with more interest from government & health professions

8. AMA Policy Statement (1999) Work collaboratively to make the health care community aware of issue Encourage development of medical education that incorporates communication Encourage the allocation of federal & private funds for research

9. Healthy People 2010 (2000) The Improvement of Health Literacy (Objective 11-2) Develop national agenda for health literacy Change practice for health professionals Enhance access to health info & health services Include health literacy in policy & program planning Enhance health literacy research & translation into practice

10. National Assessment of Adult Literacy (2003) 10 years after the original survey Health literacy component Provided the first assessment of the population's health literacy

11. Surgeon General (2002-2006) Health literacy one of Dr. Richard Carmona’s “7 public health priorities” “Health literacy is the currency of success for everything I am doing as Surgeon General” (AMA House of Delegates Mtg, 2003). Workshop on Improving Health Literacy (2006)

12. Health Literacy: A Prescription to End Confusion (2004) Increased research funds New measures Accreditation requirements for health ed Assessment as part of health care information systems (IOM, 2004)

13. Federal Funding (2004 & 2010) Substantial federal funding announced in 2004. Reissued in 2010. Goal: increase understanding of the “nature of health literacy and its relationships with health outcomes” Measurement, life course variation, outcomes, mediators and moderators, interventions, new technologies (HHS, 2010).

14. IOM Roundtable (2006-present) Building on IOM report, convened the Roundtable on Health Literacy “To move forward the field of health literacy by translating research findings to practical strategies that can be implemented” (IOM, 2010). 10 meetings

15. National Health Literacy Act (2007) Would establish a Health Literacy Implementation Center to: ▫ Coordinate health literacy activities between HHS & Dept. of Education ▫ Award grants to states to establish health literacy resource centers

16. Patient Protection & Affordable Care Act (2010) Mentioned several times - differing levels of health literacy, prescription labeling, workforce training Health Literacy & Health Care Reform Workshop (November, IOM Roundtable) “Health literacy is needed to make health reform a reality,“ HHS Secretary Sebelius

17. National Action Plan to Improve Health Literacy (2010) Based on Surgeon General’s Workshop (2006), town hall meetings (2007 & 2008) & stakeholder feedback (2009) Develop/disseminate accurate health information Promote changes in health care system Incorporate standards-based health ed

18. National Action Plan to Improve Health Literacy (2010) Expand adult education, ESOL, culturally & linguistically appropriate info services Build partnerships & change policies Increase research & evaluation Increase dissemination & use of evidence-based practices/interventions

19. Implication for Libraries “Library” or “Librarian” mentioned 46 times in 67 page report Plug for MLA training “Library professionals” named as critical School libraries fundamental Health literacy intersects with info literacy

20. Implications for Libraries Suggest consumers & health professionals use and refer to libraries Goal 2 – training for health professionals Goal 4 – appropriate information services Goal 7 – dissemination of research base

21. Questions? Amber Burtis Health Sciences Librarian Southern Illinois University Carbondale aburtis@lib.siu.edu (618)453-1448

22. Works Cited American Medical Association, Council on Scientific Affairs, Ad Hoc Committee on Health Literacy. (1999). Health literacy: Report of the Council on Scientific Affairs. JAMA, 281(6):552-557. Carmona, R.H. (2003, June). Health Literacy in America: The Role of Health Care Professionals. Speech presented at the American Medical Association. Retrieved from: http://www.surgeongeneral.gov/news/speeches/ama061403.htm http://www.surgeongeneral.gov/news/speeches/ama061403.htm Centers for Disease Control. (2007). The obesity epidemic and United States students. Retrieved from: http://www.cdc.gov/healthyyouth/yrbs/pdf/yrbs07_us_obesity.pdf http://www.cdc.gov/healthyyouth/yrbs/pdf/yrbs07_us_obesity.pdf Evans, S.J. (2008). Public Policy Issues Research Trends. Preface, vii. Nova Science Publishers: New York. Grosse R.N., & Auffrey C. (1989). Literacy and health status in developing countries. Annual Review of Public Health 10, 281-97. Institute of Medicine. (2004). Health literacy: A prescription to end confusion. Washington, D.C.: The National Academies Press. Institute of Medicine. (2010). Roundtable on Health Literacy. Retrieved from: http://www.iom.edu/Activities/PublicHealth/HealthLiteracy.aspx http://www.iom.edu/Activities/PublicHealth/HealthLiteracy.aspx National Health Literacy Act of 2007, S. 2424, 110th Cong., 1st Sess. (2007). National Literacy Act of 1991, Pub. L. No. 102-73, 105 Stat. 333 (1991). Simonds, S.K. (1974). Health education as social policy. Health Education Monograph, 2, 1–25. U.S. Department of Health and Human Services. (2000). Healthy People 2010. Retrieved from http://www.healthypeople.gov/document/HTML/Volume1/11HealthCom.htm http://www.healthypeople.gov/document/HTML/Volume1/11HealthCom.htm U.S. Department of Health and Human Services. (2010a). National Action Plan to Improve Health Literacy. Retrieved from http://www.health.gov/communication/HLActionPlan/pdf/Health_Literacy_Action_Plan.pdfhttp://www.health.gov/communication/HLActionPlan/pdf/Health_Literacy_Action_Plan.pdf U.S. Department of Health and Human Services. (2010b). Understanding and Promoting Health Literacy (R21). Retrieved from: http://grants.nih.gov/grants/guide/pa-files/PAR-07-018.htmlhttp://grants.nih.gov/grants/guide/pa-files/PAR-07-018.html