A lot recently has been bounced around on blogs and email about consumers and health information literacy. The YSN Library blog has two posts, Health Literacy of American Adults and Comments on Health Literacy of America' Adults - NEJM.

The Health Literacy of American Adults post references the results of the 2003 National Assessment of Adult Literacy (NAAL) report (download PDF of report) that measures health literacy among American adults including their ability to read, understand, and apply health-related information in English.

Findings include:

• The majority of American adults (53 percent) had Intermediate health literacy.
• Fewer than 15 percent of adults had either Below Basic or Proficient health literacy.
• Women had higher average health literacy than men.
• Adults who were ages 65 and older had lower average health literacy than younger adults.
• Hispanic adults had lower average health literacy than adults in any other racial/ethnic group.
  

The NEJM comment YSN Library blog points to is about a 64 years old man, with a "history of noncompliance," who was seen several times through out the year for diabetes and heart related issues. Finally, after several visits a medical student discovered he was illiterate. All the written instructions typed in large letters weren't able to help this man because he left school before the second grade and couldn't read.

The NEJM comment states the NAAL reports that "12 percent of U.S. adults are estimated to have below basic "document literacy," the ability to read and understand documents such as transportation schedules and drug or food labels - they may be able to sign a form, but they cannot use 'a television guide to find out what programs are on at a specific time.' In addition, 22 percent of adults are estimated to have below basic 'quantitative literacy,' the ability to perform fundamental quantitative tasks - they may be able to sum the numbers on a bank deposit slip, but they cannot compare the ticket prices for two events. Older adults fared poorest on the NAAL: 23 percent of those more than 64 years of age had below basic prose literacy, 27 percent below basic document literacy, and 34 percent below basic quantitative skills."

So I guess it should not be very surprising (although it was to me) thaaccordingng to a report by Brown University researchers (D. West and A. Miller) published in the Journal of Health Care for the Poor and Underserved (subscription required), state health department web sites are inaccessible to many (free news article). West and Miller examined state government health web sites on readability levels, disability access, non-English accessibility, and the presence of privacy and security statements.

Their findings:

20% of state health department websites were written at an 8th grade level (half of Americans read at that level).
62% of the sites were written at the 12th grade level in the same year
58% of the state sites did not meet the minimum accessibility standards recommended by disability advocates
10% of state health sites provided any kind of non-English materials

West and Miller state, "Unless these concerns are addressed, public e-health will remain the domain of highly educated and affluent individuals who speak English and do not suffer from physical impairments."

This is all important information to remember for a public librarian, consumer health librarian, or anybody else who is responsible for consumer health resources and web information. In my August 25, 2005 post, a medical center, it's community learning center, and libraries are working together to help patients understand their health conditions, provide computer and Internet training and offer tutoring for people with a range of reading skills. I think one of the key things to note is that they offer reading skills tutoring. In the case of the 64 year old man (and others like him), printing off more information or handing him a pamphlet aren't going to help.