Increasing Health Literacy Increasing Health Literacy to Change Health Outcomesto Change Health Outcomes

Alice M. Horowitz, PhDAlice M. Horowitz, PhD

Oral Health Literacy for Health Center Populations

National Institute of Dental and Craniofacial ResearchNational Institute of Dental and Craniofacial ResearchNational Institutes of HealthNational Institutes of HealthU. S. Department of Health and Human Service U. S. Department of Health and Human Service

National Primary Oral Health Care Conference

ObjectivesObjectives

To describe why addressing health literacy To describe why addressing health literacy is vital to accomplishing Healthy People is vital to accomplishing Healthy People 2010 goals & objectives2010 goals & objectives

To define oral health literacyTo define oral health literacy To review health literacy efforts to dateTo review health literacy efforts to date To consider what we can do To consider what we can do nownow in our in our

daily activitiesdaily activities

Health Literacy BackdropHealth Literacy Backdrop

Healthy People 2010 Health Communication Healthy People 2010 Health Communication Objectives & DHHS Action PlanObjectives & DHHS Action Plan

Oral Health in America: A Report of the Surgeon Oral Health in America: A Report of the Surgeon GeneralGeneral

A National Call to Action to Promote Oral HealthA National Call to Action to Promote Oral Health IOM Health Literacy: A Prescription to End IOM Health Literacy: A Prescription to End

ConfusionConfusion NIH/AHRQ Program Announcement on Health NIH/AHRQ Program Announcement on Health

LiteracyLiteracy

Health Literacy ObjectivesHealth Literacy Objectives

Improve the health literacy of persons with Improve the health literacy of persons with inadequate or marginal literacy skills (11-2)inadequate or marginal literacy skills (11-2)

Increase the proportion of persons who Increase the proportion of persons who report that their healthcare providers have report that their healthcare providers have satisfactory communication skills(11-6).satisfactory communication skills(11-6).

Almost HALF of American Almost HALF of American adults have limited literacyadults have limited literacy

Prevention & Primary CarePrevention & Primary Care

Low-literate adults are less likely to get Low-literate adults are less likely to get mammograms, Pap smears, flu and mammograms, Pap smears, flu and pneumonia vaccines or take their children pneumonia vaccines or take their children for regular doctor and dental visits. for regular doctor and dental visits. – 26% of patients a a public hospital couldn’t 26% of patients a a public hospital couldn’t

understand from their appointment card when understand from their appointment card when their next appointment was scheduled.their next appointment was scheduled.

Self-ManagementSelf-Management

Adults with low health literacy have less Adults with low health literacy have less knowledge of disease management and of health-knowledge of disease management and of health-promoting behaviors.promoting behaviors.– Low-literate asthmatics are less likely to know how to Low-literate asthmatics are less likely to know how to

use an inhaler.use an inhaler.– Low-literate diabetics are less likely to achieve Low-literate diabetics are less likely to achieve

hemaglobinA1c goals.hemaglobinA1c goals.– Low-literate adults are less likely to know the purpose of Low-literate adults are less likely to know the purpose of

fluorides.fluorides.– Low-literate adults are less likely to have good oral Low-literate adults are less likely to have good oral

health.health.

Americans have been Americans have been socialized to believe that socialized to believe that

oral health is secondary and oral health is secondary and separate from general separate from general

healthhealth

Source:Oral Health in America: A Report of the Surgeon General, 2000

The National Call to Action to Promote Oral Health The National Call to Action to Promote Oral Health stated that the #1 Action to be taken was to stated that the #1 Action to be taken was to change perceptions of oral health among: change perceptions of oral health among:

the public at large the public at large policy makerspolicy makers health providershealth providers

Change Public Perceptions Change Public Perceptions

Enhance oral health literacyEnhance oral health literacy Develop messages that are culturally Develop messages that are culturally

sensitive and linguistically competentsensitive and linguistically competent Enhance knowledge of the value of regular, Enhance knowledge of the value of regular,

professional oral health careprofessional oral health care Increase the understanding of how the Increase the understanding of how the

signs and symptoms of oral infections can signs and symptoms of oral infections can indicate general health status and act as indicate general health status and act as markers for other diseases markers for other diseases

One of the best ways for us One of the best ways for us to help increase the public to help increase the public

perceptions about oral perceptions about oral health is for each of us to health is for each of us to

educate, educate, educate educate, educate, educate

Oral health literacy is: the degree Oral health literacy is: the degree to which individuals have the to which individuals have the

capacity to obtain, process, and capacity to obtain, process, and understand basic oral and understand basic oral and

craniofacial health information craniofacial health information and services needed to make and services needed to make appropriate health decisionsappropriate health decisions

Source: Healthy People 2010

Each of us in our daily Each of us in our daily activities has opportunities activities has opportunities

to change perceptions to change perceptions about oral health about oral health

Educate pregnant Educate pregnant women about the need women about the need

for them to have for them to have healthy teeth and gums healthy teeth and gums to help ensure that their to help ensure that their

infant will be healthyinfant will be healthy

Educate parents how they Educate parents how they can prevent dental caries in can prevent dental caries in the teeth of their childrenthe teeth of their children

Educate about the need for Educate about the need for appropriate use of fluoride. appropriate use of fluoride. Determine whether patients Determine whether patients understand what fluoride is, understand what fluoride is,

how it works and why we how it works and why we need it to prevent dental need it to prevent dental

caries.caries.

We need to eradicate We need to eradicate fluoride ill-literacyfluoride ill-literacy

Ensure that you & staff have correct informationEnsure that you & staff have correct information Take courses in communicating in plain Take courses in communicating in plain

languagelanguage Educate your staff about communicating in plain Educate your staff about communicating in plain

languagelanguage Communicate with patients at their level of Communicate with patients at their level of

understanding understanding Ensure that printed materials you provide are in Ensure that printed materials you provide are in

plain language.plain language.

What you can doWhat you can do