Low Literacy and Poor Health are Directly Linked

The Research Base

• In the 1990s, Healthy People 2000 & Other Strategic Plans identify educational level as key determinant for access to health education and promotion activities and health services.
• Simultaneously, studies in non-industrialized nations indicate direct relationship between literacy level and key health indicators.
• Studies in Canada by Perrin and in the U.S. by Davis, Weiss & Williams confirm interaction between literacy level and health, linking low reading level and poor health.
• The linkage between low literacy and poor health is affirmed by Healthy People 2010, The American Medical Association (2000) and Insitute for Medicine (2004) reports.
• On the literacy side, the National Adult Literacy Survey in 1992, established that 45% of the U.S. population (90 million people) have extremely limited (20%) or limited (25%) literacy skill concentrated in minority populations.
• Health education and promotion is a key strategy in today's health care.
• However, most health education-promotion material is in print form written at or above the 10th grade level.
• Moreover, print materials frequently make assumptions and prior knowledge that lead to misunderstanding.

THEREFORE, THE 90 MILLION ADULTS WHO ARE IN THE GREATES NEED OF HEALTH EDUCATION AND PROMOTION DO NOT BENEFIT FROM CURRENT HEALTH EDUCATION PRACTICE ABOUT PREVENTION AND EARLY DETECTION.

Why Teach Health in Adult Basic Education

Poor health is interwoven with factors related to poverty such as inadequate nutrition, substandard housing, living in dangerous neighborhoods and limited access to health care. But, as the preceding statement illustrate, literacy status has emerged as a key factor in health status through studies and reports from the 1980s to present day in 2005. The health care world was shocked to learn the extent of limited literacy in America (National Adult Literacy Survey, 1993, 2003) and was especially concerned because most health education is carried out through print materials that are usually written at a difficult level. Over the last decade, health care providers have made concerted efforts to re-write materials at a simpler level but both the health and adult literacy worlds are realizing that health communications is not that simple a problem.

Adult basic education classrooms are psychologically safe environments for learning about health and where there is the luxury of time to explore health issues that are personally meaningful to students as well as to their families and communities. Students and teachers together can recognize and explore the complexity and variety of experiences, perspectives, and cultural views individuals bring to a health issue. Teachers have found that health content serves as a catalyst for literacy learning that energies curriculum and instruction and can be integrated into existing literacy activities. Health, then, becomes a vehicle for curriculum and instruction, rather than a stand-alone area that creates an additional burden on teachers. Health can also be a bridge to help programs and practitioners move toward being increasingly student-centered. So there are multiple benefits for both health care and adult literacy systems.

From a political perspective, it is important for the adult literacy system to show that it is a vital part of addressing social justice issues in this country. Teaching and learning about health in adult basic education can have great impact on studentss' health knowledge, skills to navigate a complex health system, and skills to advocate for themselves and their families. It is a place where a positive experience with health education can set the stage for lifelong learning about health. Adult learners can gain increased control over their own health, as well as the health of their family members.

Interested in reading more about a participatory action research project on which the preceding is based? Go to http://www.nifl.gov/nifl/fellowship/reports/hohn/HOHN.HTM.