Andres,

Many years ago Tom Sticht did a Functional Context Education workshop  
at Harvard.  He pointed out that literacy is a two-sided coin, that  
we need to teach people to read (better), but we also need to write  
better.  He said if it were up to him no one would graduate from  
college without being able to write at a 5th grade level.  I think he  
meant that an important part of good written communication is plain  
language, and I agree.  I also like that Tom shifted part of the  
"literacy responsibility" to writers.  Literacy, and health literacy  
by extension, is communication. As Argentinians might say,  it takes  
two to Tango.  : - )

David J. Rosen
djrosen at comcast.net


On Oct 11, 2006, at 12:37 PM, Muro, Andres wrote:


> Bob: I agree with part of what you are saying. In essence, I agree  

> that health literacy should not be limited to multicultural  

> communities. What I am interested about the definition that NYC  

> adopted is the inclusion of the health professionals and entities.

>

> The current definition by HHS, roughly paraphrased, is that health  

> literacy is the knowledge that people need to have to access and  

> use services. This puts the burden on the community at large to get  

> to the level of the providers. My argument is that the providers  

> need to be health literate so that they can communicate with the  

> community at large.

>

> So, for example, if a doctor is familiar with and can diagnose  

> hypertension, he needs to know that the term that many members of  

> the community at large use is usually high blood pressure. If the  

> doctor is not using high blood pressure to explain to the patient  

> the condition, then, the doctor is not community health literate.  

> The doctor must become community health literate in order to  

> adequately serve the community at large.

>

> I am arguing that by modifying the definition of health literacy we  

> are asking the doctor to assume some of the responsibility. This  

> extends to all health workers.

>

> Andres

>

> -----Original Message-----

> From: healthliteracy-bounces at nifl.gov [mailto:healthliteracy- 

> bounces at nifl.gov] On Behalf Of Dickerson, Robert

> Sent: Tuesday, October 10, 2006 4:45 PM

> To: The Health and Literacy Discussion List

> Subject: [HealthLiteracy 442] Re: Your presentation on health literacy

>

> I've been watching the discussion on the health literacy definition. I

> would have to agree with Cynthia Baur's comments. We need to be  

> careful

> when defining health literacy that the definition is not too limiting.

> We also need to make sure the definition itself is understandable.

>

> While I very much appreciate that Andres is emphasizing the

> multicultural and multilingual aspects of understanding, her  

> definition

> limits health literacy to communities that are multicultural and

> multilingual. "The capacity of individuals in a multicultural and

> multilingual community...". By having narrowing the definition are we

> going to exclude communities that are homogeneous? People new to  

> health

> literacy may.

>

> I have had several discussions (e-mail) with a very prominent  

> physician

> in our state who vehemently argues none of his patients have problems

> with health literacy. He insists they all understand what he tells  

> them.

> With a definition such as this I can very well see this individual

> making the assumption that health literacy is limited to people who do

> not speak English and/or come from cultures different than our own.

>

> The HHS definition does not limit health literacy to any one type of

> patient or community.

>

> Creating easy to understand materials and communicating clearly are

> strategies to improve health literacy. The role of the health care

> provider and health worker in doing this, to me has always been  

> implied.

> In the many presentations I have given on health literacy,  

> difficult to

> understand materials and poor communication are always things that I

> discuss as contributing to low health literacy and clear  

> communication.

> Using easy to understand materials are strategies I outline for

> enhancing health literacy. These are essential to a complete  

> discussion

> of health literacy but do not define it. As such I think it does not

> really fit in the definition of health literacy but is essential to

> enhancing it.

>

> During my presentations I have found people sometimes have difficulty

> clearly understanding the HHS definition of health literacy on the

> initial read. After we talk very briefly about what it is saying they

> have been able to read it and have it make sense. In the true  

> nature of

> making things easy to understand it truly is not written at an easy to

> understand level (it is long and has several difficult to understand

> terms). However, it seems to have been universally accepted and as  

> such

> I would urge caution developing differing definitions. Adding to it  

> only

> makes it less reader friendly, more difficult to understand and

> potentially limited.

>

> I respect opinions may differ. By having a common definition that  

> is not

> limited to specific patient populations and clearly identifying and

> employing similar strategies to enhance health literacy we can  

> present a

> common front. By creating varying definitions we become too fragmented

> in what we trying to improve and risk loosing sight of what our aim  

> is.

> I believe, if I am not mistaken, our aim with health literacy is

> something to the effect of improving communication and  

> understandability

> of health related information for all people.

>

> Thanks very much,

> Bob

>

> Bob Dickerson, MSHSA, RRT

> Clinical Resource Coordinator, Clinical Quality

> Iowa Health - Des Moines

> Des Moines, Iowa

> Phone: (515) 263-5792

> Fax: (515) 263-5415

> E-mail: DICKERR2 at ihs.org

> Website: www.ihsdesmoines.org

>

>

> -----Original Message-----

> From: healthliteracy-bounces at nifl.gov

> [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Baur, Cynthia

> (HHS/OPHS)

> Sent: Tuesday, October 10, 2006 1:01 PM

> To: The Health and Literacy Discussion List

> Subject: [HealthLiteracy 441] Re: Your presentation on health literacy

>

> I appreciate the lively discussion of the meaning of health literacy.

> The HHS Health Literacy Workgroup has always used the broadest  

> possible

> definition of health literacy, and we already recognize health

> professionals as part of the problem and solution. All types of health

> professionals work at HHS, and we have always been very clear that

> improving health literacy is everyone's responsibility. For an

> elaboration of the role that we see health professionals playing,  

> please

> see our Quick Guide to Health Literacy that was developed for HHS

> employees. We have made this available on our web site for anyone to

> use. www.health.gov/communication, in the health literacy section.

>

> Cynthia Baur, Ph.D.

> Senior Health Communication and e-Health Advisor Office of Disease

> Prevention and Health Promotion U.S. Department of Health and Human

> Services

> 1101 Wootton Parkway, LL

> Rockville, MD 20852

> 240-453-8262

> Cynthia.Baur at hhs.gov

>

>

>

> -----Original Message-----

> From: healthliteracy-bounces at nifl.gov

> [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Muro, Andres

> Sent: Tuesday, October 10, 2006 12:42 PM

> To: The Health and Literacy Discussion List

> Subject: [HealthLiteracy 440] Re: Your presentation on health literacy

>

> Hey Anthony, that is great. Now, if we can get HHS to adopt the

> definition. Cynthia, are you there ;-)

>

> Andres

>

> -----Original Message-----

> From: healthliteracy-bounces at nifl.gov

> [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Tassi, Anthony

> Sent: Tuesday, October 10, 2006 9:04 AM

> To: The Health and Literacy Discussion List

> Subject: [HealthLiteracy 439] Re: Your presentation on health literacy

>

> I agree that Andres has succinctly captured what many of us have been

> thinking for years.  Here in NYC, we have incorporated this  

> approach in

> the definition that we are using:

>

> http://www.nyc.gov/html/adulted/html/health/health.shtml

>

> Anthony Tassi

> Director, Adult Education

> Office of the Mayor

> City of New York

> atassi at cityhall.nyc.gov

>

>

>

> www.nyc.gov/adult-ed

>

>

> -----Original Message-----

> From: healthliteracy-bounces at nifl.gov

> [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Julie McKinney

> Sent: Friday, October 06, 2006 1:42 PM

> To: healthliteracy at nifl.gov

> Subject: [HealthLiteracy 437] Re: Your presentation on health literacy

>

> Thanks Andres,

>

> I like the way your new definition of health literacy (at the end)

> includes skills for health workers to achieve in order to be health

> literate. It is a new way of looking at it! Please let us know  

> about the

> response you get from the presentation, if you could.

>

> Thanks again,

>

> Julie

>

> Julie McKinney

> Discussion List Moderator

> World Education/NCSALL

> jmckinney at worlded.org

>

>>>> amuro5 at epcc.edu 10/06/06 1:10 PM >>>

> Julie:

>

>

>

> It is my own presentation. However, it is attached. Let me know if you

> have questions.

>

>

>

> Andres

>

>

>

> ________________________________

>

> From: healthliteracy-bounces at nifl.gov

> [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of  

> jbaker3439 at aol.com

> Sent: Friday, October 06, 2006 10:37 AM

> To: healthliteracy at nifl.gov

> Subject: [HealthLiteracy 434] Your presentation on health literacy

>

>

>

>  Andres,

>

>

>

> Although I would love it, I am not able to attend the Health Literacy

> Conference next week.  However, I was wondering if your  

> presentation is

> available for those of us who are unable to attend.

>

>

>

> Are you part of a group from NCES or DOE that is disseminating

> information about NAAL, or is this a presentation that you have  

> designed

> yourself?

>

>

>

> Thanks for your time.

>

>

>

> Julie Baker

>

>

>

>

>

> Julie N. Baker

>

> Workforce Skills Development

>

> 13805 Shaker Blvd., #4A

>

> Cleveland, OH 44120

>

> 216-561-1629

>

> jbaker3439 at aol.com <mailto:jbaker3439 at aol.com>

>

>

>

>

> -----Original Message-----

> From: amuro5 at epcc.edu

> To: healthliteracy at nifl.gov

> Sent: Thu, 5 Oct 2006 1:08 PM

> Subject: [HealthLiteracy 430] health literacy conference San Antonio

>

> There is a health literacy conference in San Antonio next week.  

> I'll be

> doing a presentation about NAAL results and other things. The  

> website is

> listed below,

>

>

>

> http://www.sahealthlit.org/save2006.pdf

>

>

>

> Andres

>

> ________________________________

>

>

>

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

>

> National Institute for Literacy

>

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>

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David J. Rosen
djrosen at comcast.net