1. National Assessment of Adult Health Literacy, Understanding the Results and Implications Andres Muro 1115 N. Oregon, El Paso, TX 79902 (915) 831 4161 andresmuro@aol.com

2. What is literacy?  Social, cultural and communication practices in a community that allow members to fully participate on all aspects of family, education, vocation and community life. In our community it usually refers to the use of print and other non-verbal clues

3. NAAL 2003

4. What is literacy?  Literacy does not immediately transfer from context to context  Being literate in one context does not make us literate in another

5. Examples of contexts  Buying groceries  Cooking a meal  Operating a electronic cash register at a grocery store  Getting an airplane ticket form the automatic ticket dispenser  Buying a metro subway card  Navigating the health care system

6. How de we get information?  Oral society  Literate society

7. What is health literacy?  The capacity of individuals in community to obtain, process and understand, health related information to make informed health decisions (HHS definition) Healthy lifestyles/prevention Access Understand/follow directions

8. NAAL results  http://nces.ed.gov/NAAL/index.asp? file=AssessmentOf/HealthLiteracy.a sp&PageId=12

9. Health NAAL overall results

10. Naal results by gender

11. Naal results by age

12. NAAL results by ethnicity Percentage of Whites in each literacy level Percentage of Blacks in each literacy level Percentage of Hispanics each literacy level Below basic: 9% Basic: 19% Intermediate: 58% Proficient: 14% Below basic: 24% Basic: 34% Intermediate: 41% Proficient: 2% Below basic: 41% Basic: 25% Intermediate: 31% Proficient: 4%

13. Literacy and health  While we are still an oral society, the medical/health system expects us to be hyper-literate.  What can we do? increase the health literacy of the general population Make the medical/health care system aware of our limitations and provide interventions to address them.

14. Re-defining health literacy  The capacity of individuals in a multicultural and multilingual community to obtain, process and understand, health related information to make informed health decisions (HHS definition); and the ability of health workers to create and share health information so that community members can make informed health decisions.

15. Interventions by health entities  Creating more accessible print materials  Creating videos, illustrated brochures, internet accessible information, etc to increase comprehension  Train health professionals to understand cultural and literacy barriers  Train health professionals on how to interact with people and how to elicit information and understanding Effectiveness of interventions by themselves is ambiguous. Must be combined

16. Interventions by health entities  Oracy: ability to use verbal information  Always elicit feedback to assess comprehension

17. Health literacy and education  Systematically incorporate health instruction in: K-12 College Adult education

18. How do we teach literacy?  Academic vs. Information Use health related information to teach reading, writing and math