Health Literacy: The Currency of a Globalized Health Professional Education Andrew Pleasant, Ph.D. Senior Director for Health Literacy and Research Canyon Ranch Institute Institute of Medicine April 23, 2015 Envisioning the Future of Health Professional Education A Public Workshop of the Global Forum on Innovation in Health Professional Education What is Health? 1
What is Health? Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. -World Health Organization Health is a resource for everyday life, not the objective of living. - Ottawa Charter for Health Promotion What is Literacy? 2
What is literacy? Learning to read? Acquiring numeracy skills? Reading to learn? The ability to change the world? What, then, is Health Literacy? 3
At the most basic level Everyday problems and skills Take 1 pill 3 times daily 245 mg sodium Trans fat 3g Radiography Health is increasingly complex Increasing amount of health knowledge New areas of research and practice (genomics) More global movement of people and ideas New and emerging infectious diseases Increasing numbers of immigrants, elderly A changing global burden of disease from acute to chronic diseases 4
Increasingly complex health systems Health systems trying to reform globally Health information = multiplication of sources Health insurance = complex bureaucracy Chronic disease prevention = lifestyle changes Chronic disease treatment = self-management often involving technology Acute issues = doctor/patient communication Medical mistakes = checklists; navigation Low health literacy causes poorer health Multiple studies reporting Poorer overall health Less likely to make use of screening and preventive services Present for health care in later stages of disease More likely to be hospitalized Poorer understanding of treatment and their own health Lower adherence to medical regimens Lower referrals to kidney transplants Die earlier Cost more 5
Health professionals and systems create demand for health literacy Health Literacy in the U.S. (NAAL, 2005) 12% 14% 52% 22% Below Basic Basic Intermediate Proficient PLUS: 3% could NOT be tested 88% of U.S. Adults below Proficient level That is nearly 9 out of every 10 adults! 6
Correlates to health status Excellent 8 17 57 19 Very good 9 19 59 13 Below Basic Good 16 27 51 6 Basic Intermediate Fair 33 30 34 3 Proficient Poor 42 27 29 3 0 20 40 60 80 100 % of total Health literacy in Europe Eight nation average (variation exists) Excellent Health Literacy 16.5% Sufficient Health Literacy 36.0% Problematic Health Literacy 35.2% Inadequate Health Literacy 12.4% }83.6% www.health-literacy.eu/ 7
Calgary Charter on Health Literacy FIND EVALUATE UNDERSTAND COMMUNICATE USE Always build this logic model on a foundational awareness of: Fundamental literacy - if your language fails, you fail. Scientific literacy - if you remove the science, you fail. Cultural literacy - if you ignore culture, you fail. Civic literacy - if you don t engage and empower people, you fail. http://tinyurl.com/kjbto52 Global examples of Health Literacy in Health Professional Education Country Institution Program Description All Australia Australia Belgium International Union on Health Promotion and Education Deakin Flinders Université Catholique de Louvain Continuing Education/ Conferences Health, and Art/Education Health Education, and General Health sciences Master of Public Health, Master of Psychology Health literacy a strong theme with a global working group 8
Global examples of Health Literacy in Health Professional Education Country Institution Program Description Canada Canada of Victoria Public Health Agency of Canada Nursing; BA in Health & Community Services, School of Public Health Online course in Public Health Portugal Lisbon Public Health Scotland Glasgow Caledonian Undergrad and Postgraduate Nursing, Podiatry, and Physiotherapy Switzerland of Berne Master of Public Health Integrated topic Continuing education for public health practitioners Module on Lifestyles and Health Literacies Global examples of Health Literacy in Health Professional Education Country Institution Program Description Germany Israel Netherlands Global Bielefeld Three universities Maastricht The World Network (20-30 universities) Teacher training, Educational Science, Social Work & Sociology Master of Public Health Public Health Health Promotion, Physician training, Nursing Several lectures Lectures Global effort to provide grounded teaching materials for faculty; coordinated educational research agenda 9
Health Literacy: Improving Health, Health Systems, and Health Policy Around the World: July, 2013 Workshop Summary http://www.ncbi.nlm.nih.gov/books/nbk202438 / IOM Commissioned Papers: Health Literacy Around the World Part 1 http://tinyurl.com/kklth5u Health Literacy Around the World Part 2 http://tinyurl.com/nlr7qkx For more information Andrew Pleasant, Ph.D. Canyon Ranch Institute andrew@canyonranchinstitute.org 520.239.8561, ext. 4147 www.canyonranchinstitute.org 10