Hi,

But would you feel it at least partially fair to say that errors made 
by professionals are a function of their  health literacy?  I am 
equally disquieted by the assumption that health literacy is 
something that only the public has or does not have. (i.e. that only 
patients make 'literacy related errors' while professionals make 
'medical errors'.... and what about when medical professionals become 
patients .. do they suddenly have heath literacy?)

Consider the growing awareness of the valuable role checklists can 
play in preventing errors by medical professionals (surgeons in 
particular). Is a checklist not health literacy? (For example .. see 
http://www.who.int/bulletin/volumes/86/7/08-010708/en/index.html)

And why are all those materials so poorly written ... is that not 
caused by poor health literacy skills on the part of the creators?

To the extent people agree those examples are also health literacy, 
then health literacy quickly accounts for a bulk of the cost estimate 
Julie shared ... even as we agree the cause in each individual 
instance is difficult to parse out methodologically.

The field has often asserted health literacy is two-sided, but as 
often makes an unequal distinction between the sides. I think this 
also extends to the recent discussion of treatment refusal. Embedded 
into that exchange was an assumption that science was infallible and 
unchanging. I would not want to be the health educator who was so 
adamant about - for example - hormone replacement therapy only to 
wake up one day and find that the science had radically changed.

In my view, health literacy should not be about gaining compliance 
but should be about giving people the tools to navigate science - 
including when science changes - to make an informed decision. I can 
think of at least one study that found people with the highest levels 
of education (Ph.D.s and similar) are among those more skeptical of 
science. An informed decision does not necessary mean compliance with 
science. An informed decision evaluates and balances the science 
along with the cultural, civic, and fundamental skills, abilities, 
and beliefs that are relevant and important to each individual.  (See 
http://www.josseybass.com/WileyCDA/WileyTitle/productCd-0787984337.html)

Best as always  ...

Andrew Pleasant




>Hello...

>I will certainly think of my 'favorite' fact but I cannot resist 

>commenting on the one just posted.

>

>It is not correct to state that people cannot do any of the tasks 

>noted. A more appropriate way to say this is "people below level X 

>have difficulty completing this task with accuracy and consistency" .

>

>What is missing from this insight [and it is valuable measure and an 

>important insight] is the critical finding from over 800 published 

>studies that health materials are generally poorly written and 

>designed.

>

>so... this does lead to my favorite assertion taken from the IOM report:

>

>Health literacy is a shared function of social and individual factors. page 4

>or

>Health literacy is a shared function of cultural, social, and 

>individual factors. Both the causes and the remedies for limited 

>health literacy rest with our cultural and social framework, the 

>health and education system that serve it, and the interactions 

>between these factors. page 32

>

>

>in addition:

>The cost research is not firmly established nor uniformly accepted. 

>It is not possible, for example, to differentiate between costs due 

>to medical errors [errors made by professionals] and costs due to 

>literacy related errors [errors made by patients]. I am very 

>disquieted by the assumption that costs are due to patient error or 

>to patient deficits.

>

>Rima

>

>Rima E. Rudd, ScD, MSPH

>Department of Society, Human Development & Health

>Harvard School of Public Health

>677 Huntington Avenue

>Boston MA 02115

>Phone: 617 432 1135

>fax:     617 432 3123

>web:    www.hsph.harvard.edu/healthliteracy

>www.hsph.harvard.edu/sisterstogether

>----------------------------------------------------

>National Institute for Literacy

>Health and Literacy mailing list

>HealthLiteracy at nifl.gov

>To unsubscribe or change your subscription settings, please go to 

>http://www.nifl.gov/mailman/listinfo/healthliteracy

>Email delivered to pleasant at aesop.rutgers.edu

>



-- 

Save the Date for the First New Jersey Health Literacy Summit on 
April 3, 2009.  See: 
http://www.advancinghealthliteracy.org/healthliteracysummit2009.swf
or
http://www.advancinghealthliteracy.org/NJhealthliteracysummit2009.pdf

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