Health Literacy

 Health Literacy is the degree to which people have the ability and the capacity to obtain, process and understand health information and the services needed to make appropriate health decisions. It has a direct influence on people’s access to crucial information about their rights and health care and ability to participate in their own care, the health service and health system. It is incumbent on the relevant systems, services and professionals to provide access and opportunity for all citizens. Health literacy is necessary for the development of social capital and seeks to address health inequalities.

 Current Research                                                                                                                  

• Health literacy measurement incorporated into Health Omnibus Survey 2008, Department of Health

The NVS is currently incorporated in the Spring Omnibus, Health Omnibus Survey 2008, SA Health.

The survey data obtained showed that around 50 per cent of South Australians lack basic health literacy (Adams et al, Med J Aust 2009;191:530-534). People with inadequate health literacy were significantly more likely to report having diabetes, cardiac disease or stroke, and significantly less likely to have recently attended a doctor. Respondents aged > 65 years with inadequate health literacy were more likely to have been admitted to hospital (OR, 2.2; 95% CI, 1.1–4.5). This publication has attracted considerable recent media interest.

Among people with asthma, those with inadequate health literacywere more likely to report wakening at night weekly or more often and hospitalizations in the past year, and were significantly morelikely to report days lost from usual activities in the past12 months (Adams et al, J Allergy Clin Immunol 2009;124:601-603).

•  Swiss Health Literacy

In collaboration withA/Prof Jen Wang, Institute for Social and Preventative Medicine, University of Zurich, we have survey 500 adults in South Australia with the new Swiss Health Literacy instrument. This tool is an exciting new development in the measurement of health literacy and is also the basis of the European Health Literacy Survey Project, an EU project to measure health literacy across Europe. Data is currently being analysed.

•  LUFLI Study

The LUFLI Study is a NHMRC-funded clinical trial examining the safest and most effective way of diagnosing asthma in older people (55 y.o. and above) in general practice of a random community group of people with respiratory symptoms but no current respiratory diagnosis. The testing included The Newest Vital Sign (NVS) and pharmacy label component of TOFHLA. It was found that 33% were likely to have a low level of health literacy and that 10% were likely to have a very low level of health literacy. It was interesting to note that the percentage scores indicating levels of low and very low health literacy increased with age, and that most participants scored well with the reading of a drug label.

•  Environmental Audit of The Queen Elizabeth Hospital (TQEH), Woodville, SA

The Environmental Audit is a tool developed by Rima Rudd, Harvard University, USA to assess the ease of navigation of the hospital environment and the health literacy implications for consumers.

The audit was conducted at TQEH in early 2008 and results were presented at the HLA meeting, 18^th June 2008.

• Health literacy measurement incorporated into North West Adelaide Health Study

The NVS and the reading component of TOFHLA are currently being assessed in Stage 3 of the North West Adelaide Health Study(NWAHS). Also within NWAHS will be an assessment of perception of risk and knowledge of cardio-vascular disease.

•  Health literacy measurement incorporated into FAMAS

The NVS is currently being assessed in Florey Adelaide Male Ageing Study (FAMAS).

•  ARC Research Grant Post-doctoral Research Fellows

As part of the successful NOBLE Stage 2 ARC Linkage Grant post-doctoral Research Fellows will be appointed who will have a specific focus on health literacy as it applies to the health of baby boomers and workforce participation

•  The Health Observatory Post-doctoral Research Fellow

The process is underway of appointing a Post-doctoral Research Fellow who will focus specifically on health literacy as a key component of healthy aging.

• International Collaboration

Meetings in Zurich have been held October 2008 and October 2009 between A/Prof Robert Adams, Prof David Wilson and A/Prof Jen Wang, Institute for Social and Preventative Medicine, University of Zurich to enhance international collaboration. We are also collaborating partners with the European Health Literacy Survey Project. We are conducting further analysis of the ABS Lifestyle Skills Survey in collaboration with international partners to allow comparisons across a number of European countries.

 Community Engagement

The South Australian Health Literacy Alliance

The South Australian Health Literacy Alliance (HLA) was formed as a direct response to the recommendations of the 2007 Adelaide Thinker-in-Residence, Prof Ilona Kickbusch. The HLA membership has considerable expertise and experience across a range of health literacy issues. The work and purpose of the Alliance aligns closely with a number of recent national and state policy recommendations and initiatives. These include:

• The National Safety and Quality Frameworkfrom the Australian Commission on Safety and Quality in Health Care;
• The National Health and Hospitals Reform Commission Report 2009;
• The draft National Primary Health Care Strategy;
• The Government’s response to The Report of 2007 Adelaide Thinker-in-Residence, Prof Ilona Kickbusch; and the
• SA Health Strategic Plan and the SA Safety & Quality Framework and Strategy.

 Professor Adams is the inaugural Chair of the HLA.

The vision of the HLA is that all South Australians are empowered to make sound health decisions in everyday life.  The mission of the HLA is to provide leadership and support for developing and applying the concept of health literacy as a means of equitably improving health and well-being. Achieving this requires 4 major avenues of action: advocacy and communication, development of capacity, research, monitoring and evaluation.