[NIFL-HEALTH:4046] RE: Health Information Literacy - a definition

From: Sandra Smith (sandras@u.washington.edu)
Date: Fri Jul 11 2003 - 13:28:42 EDT


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From: "Sandra Smith" <sandras@u.washington.edu>
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Subject: [NIFL-HEALTH:4046] RE: Health Information Literacy - a definition
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Erica, Listmates:
Glad to know the MLA is working on this. The working definition sets a very
high standard. It implies specialized knowledge of health & medicine, health
resources; computer literacy; self-advocacy, and a high level of
self-efficacy. Synthesis and analysis are advanced literacy skills rarely
taught in schools. It may be that only medical librarians can meet this
definition.

Health literacy definitions have similarly high and perhaps unreasonable
expectations of patients and the public. Such definitions do a disservice
when individuals are labeled 'low health literate' or having  'marginal
health literacy skills', particularly when in the interest of convenience
for journal readers the labels are shortend to simply 'illiterate'. WHen
such labels make it into poorly protected medical records they can
jeopardize employment and relationships. Furthermore, such definitions and
labels may serve best to deflect responsibility for bridging comminication
gaps from health professionals to patients. In the US, federal and state law
and accreditation standards clearly place responsiblity for patient
understanding with the professional.

An essential question for definition developers is What will we do
differently because of the definition? Will we treat people differently when
they 'fail'?

When a person needs health & medical information, they are almost certain to
be stressed emotionally, financially, spiritually and mentally. Stress
impairs congitive function.  Illness and medication, unfamiliar surroundings
and fear interfere with cognitive function. The NALS introduced the concept
of functional literacy which says a person may be highly literate in some
situations (familiar surroundings, usual routines, using information
directly related to their job or their specialty). The same person becomes
rapidly less functionally literate when ill, stressed, medicated, in
unfamiliar settings, readin or hearing unfamiliar terms  describing
unfamiliar topics.

Helathcare and Medicine each have their own language, full of specialized
and 'common' terms which are rarely heard in everyday conversation and rife
with everday terms to which we assign special meaning (provider, stool,
screen, a negative test result is positive and a positive result is negative
unless its a false positive) Can we ethically require patients to come
around to our (highly trained and unique) ways of thinking and using the
language in order to benefit from our services?

All this suggests to me  that everyone is likely to be 'health illiterate'
at the time they need health information. It seems senisible then to assume
that everyone has low health literacy and low health information literacy
and to employ universal precautions that focus on what we can do to better
serve patients/clients instead of on the patients' deficiencies.

Sandra Smith, MPH CHES
800-444-8806
Health Education Specialist
University of Washington
Center for Health Education & Research
Edito, Beginnings Guides
sandras@u.washington.edu


-----Original Message----- From:Erica Burnham


t our goal is to define health *information* literacy, and the librarian's
role in this area. Is there
a difference between "health literacy" and "health information
literacy"?

Our working definition is as follows: Health Information Literacy is the set
of knowledge and skills needed
to: recognize a health information need; .	identify likely information
sources in an appropriate format and
use them to retrieve relevant information; assess the quality of the
information and its applicability to a
specific situation; analyze, understand, and synthesize the information; and
apply the information to make good health decisions.
[Medical Library Association, 2003]



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