1. A Vision for a More Health Literate Missouri: Building a Statewide Health Literacy Center Center for Plain Language Symposium November 7, 2008 National Press Club Washington D.C. Arthur Culbert, Ph.D. Senior Advisor to Missouri Foundation for Health

2. Definition Health Literacy is “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” ( Healthy People 2010)

3. Low health literacy contributes to: – Misunderstanding – Mistakes – Excess hospitalizations – Poor health outcomes – Unnecessary deaths

4. Size of the problem  Low health literacy: U.S. 90 million MO. – 1.6 million

5. Size of the problem

6. Estimated annual costs of low health literacy to the economy U.S. $106 to $238 billion Missouri $3.3 to $7.8 billion Vernon J. et al, 2007

7. Cost of Low Health Literacy in Missouri

8. Today’s talk State wide efforts in health literacy Health Literacy Missouri (HLM) Role of plain Language

9. State’s Efforts Midwest – Minnesota Health Literacy Partnership ‘06 – Iowa Center for Health Literacy ‘08 – Wisconsin Literacy Inc. ‘08 – Health Literacy Missouri ‘09

10. History MFH discovered health literacy components in previous proposals (2002-2005) Awarded $2.1 million in 2007 as part of 5 years funding Open a statewide health literacy center in 2009

11. Guiding Principles Engage Community Partners – Inclusive – Responsive – Relationship Building Put Consumer First – User Driven – Easy to Use – Sustainable Innovate Strategically – Find niche

12. Vision and Mission The vision of Health Literacy Missouri is to become a national leader in health literacy with a mission to improve the health of all Missourians.

13. DOES NOT BLAME VICTIM, but rather Creates systematic change in provider patient encounter environment Offers educational resources that help providers communicate effectively with patients Provides access to plain language health care information Philosophy

14. Partners

15. Systems Thinking  Coordinating Council Engage in open dialogue Build collaboration to create “group genius” Determine consensus of priorities Develop strategic plan for the Health Literacy Missouri Center to open in 2009

16. Activities Health literacy and plain language – Retained Maine Health Literacy Institute to provide training in clear health communication to all involved in HLM

17. Activities Identified priority health literacy needs and concerns of Missourians Completed a national survey of health care journalists Conducted extensive open-ended interviews with 100 health literacy leaders

18. Activities Raised visibility of HLM – Cosponsored with CDC town hall meeting May 2008 – Incited activity in health literacy with in Missouri Determined economic cost to Missouri Field testing living with diabetes guide developed by the American College of Physicians Supporting the development of GSI mapping software to determine ‘hot spots’ of low literacy

19. Hot spots of low literacy

20. St. Louis Health Literacy Level by Tract

21. Activities Identified 10,000+ health literacy resources – Classifying by type and developing criteria for evaluating – Inventory of health literacy resources will: Be easily accessible Be well organized Be user friendly Meet user's needs Target community- based organizations, health care providers, adults with low health literacy

22. Health Literacy Depot Step 1 : visit http://www.healthliteracymisouri.org/ (open to the public in December 2009) http://www.healthliteracymisouri.org/ Step 2 : click on Health Literacy Depot

23. Health Literacy Depot Step 3 : Choose from a drop down the area of health literacy you are interested in addressing – Developing plain language documents – Creating shame free patient provider environment – Developing appropriate signage within an organization – Creating an evaluation instrument to measure the success of an organization’s efforts to remedy low health literacy in the work place

24. Health Literacy Curriculum Target Population: ALL health professions students, and providers Activities: – Curricula to raise awareness and provide best practices for health professional students and providers – Health literacy training through Missouri AHEC pre- health professional students

25. Demonstration Projects Engage the community in creative ways to advance health literacy

26. Demonstration Projects

27. Social Marketing Health literacy awareness campaign across Missouri – Strategic press releases developed and delivered monthly to: 265 newspapers 35 Television stations

28. Strategic Communications Work Each press release begins as a template, to be localized for each region

29. Strategic Communications Work Local graphics are created for each region. Research has shown that including graphics with the release increase the chance of having it used.

30. Strategic Communications Work With the graphics in place, the local quotes, statistics and other information is inserted and then the release is sent out to the targeted media

31. Health Literacy Surveillance Target Population: general public and health care providers Activities – Plan and administer assessments of health literacy to the general public and health care professionals – Analyze data and report findings – Findings will serve as baseline measures to evaluate year-to-year progress in health literacy

32. Conclusion Yes We Can!! Lots going on Building on Foundation of plain language Strategy for reforming health care