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Health Literacy

Health literacy is “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions”.1 It informs or limits an individual’s ability to search for and use health information, adopt healthy behaviors, follow prescribed treatment plans, and act on important public health alerts. Limited health literacy is associated with worse health outcomes and higher costs2 and in the collegiate population can also lead to impaired student success. Health literacy is not only about individuals’ skills; in the United States, health literacy reflects the efforts of health systems and professionals to make health information and services understandable and actionable. Interventions across multiple sectors need to focus on improving individual skills and making health service, education, and information systems more health literate.2


Key Facts

  • Nearly 9 of 10 adults have difficulty using the everyday health information that is routinely available in our healthcare facilities, retail outlets, media, and communities.1,3,4
  • The average annual healthcare costs of those with low health literacy levels are 4 times greater than that of the general population.5,6,7
  • Poor health literacy costs the U.S. healthcare system $30-$73 billion annually.5,6
  • 90 million Americans lack the skills needed to understand and act on health information.9
  • Individuals with low health literacy are less likely to participate actively in healthcare decision making and more likely to struggle with health management tasks and to face significant challenges navigating the health system. 9
  • Approximately 9 of 10 U.S. adults (88%) cannot calculate an employee's share of health insurance costs using a table based on income and family size.3
  • Health literacy is a better predictor of one’s health status than: age, income, employment, ethnicity, or education level.10,11
  • In 2006, 3 million Americans reported being seriously harmed or knowing someone who has been seriously harmed by following health advice or information found online.1

Suggestions for Faculty

This page is intended to be a resource containing suggestions for what you can do to increase NYU students’ capacity to make appropriate healthcare decisions.

Be knowledgeable about NYU’s health and wellness services for students and able to refer them to the appropriate resources when necessary. The Student Health Center is comprised of a comprehensive set of medical, counseling, and ancillary services. These include but are not limited to the NYU Wellness Exchange with 24/7 crisis response, Physical Therapy, Radiology, Allergy and Travel Medicine, Psychiatry, Specialty Services, Optometry, Pharmacy Services, Health Promotion, and the Moses Center for Students with Disabilities. Whether enrolled in an NYU-sponsored Student Health Insurance plan or maintaining alternate health insurance coverage, the Student Health Center offers routine and walk-in Primary Care and Women's Health Services at either no cost or very reduced cost to all matriculated NYU students. In addition, Wellness, Short-term Counseling (talk therapy) and Crisis services are free of charge. Visit the NYU Student Health Center website to learn more about specific services, hours of operation, and how students can make an appointment.

Avoid requesting an “excuse note” from students who miss class due to illness. The NYU Student Health Center does NOT issue “excuse notes” to students no matter how ill the student may be. Additionally, unnecessary visits to the Student Health Center can increase the spread of communicable illnesses and impair a student’s capacity to rest and get well at home.

When discussing how to utilize online sources and detect trustworthy versus unreliable sites, remind students that these same rules apply to the sources they use in their personal lives. The Internet is the primary source of health information for NYU students.39-41 Just as students should only use credible resources for their research papers, remind them to be skeptical of online health sources and to use the same research method skills to evaluate the quality of health information sources.  Visit the National Institutes of Health's Medline Plus Evaluating Health Information guide for additional resources to help students detect and use reliable health information.

If you are made aware of a student who is having difficulty navigating healthcare systems, communicate with the Student Health Center (by calling 212 443 9999) on both the specific student (if they consent) or even on general issues you are hearing about. This will allow the Student Health Center to craft improved communications, while ensuring individual student needs are met.

For faculty involved with students travelling/studying abroad, familiarize yourself with site-specific travel insurance, emergency protocols, and local health resources. For more information, visit the NYU Global Academic Center's Information Page or NYU Traveler.


health literacy indicators

 


a) Provision of health education by NYU Student Health Center during patient visits

  • Data Source: Customer Satisfaction Survey #20
  • Survey Question: I received information during my visit that I will use to improve my health
  • Definition:

b) Students who incurred unexpected charges after receiving medical or mental services

  • Data Source: ACHA – custom question
  • Survey Question: True or False: In the last 12 months, when I received medical or mental health services (whether at the NYU Student Health Center or elsewhere), the charges I incurred were always what I expected.
  • Definition: of those who received services, proportion who responded “false” (does not includes N/A in denominator)

c)  Confused by online health information

  •  Data Source: ACHA – custom question
  • Survey Question: At any point in your last search for health information online did you feel any of the following things? (Select ALL that apply)
  • Definition: proportion who endorsed “Confused by the information you found online”

  1. Nielsen-Bohlman, L., Panzer, A.M., & Kindig, D.A. (2004). Health Literacy: A Prescription to End Confusion. Washington, DC: Committee on Health Literacy. Board on Neuroscience and Behavioral Health. Institute of Medicine of the National Academies.
  2.  U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. (2010). National Action Plan to Improve Health Literacy. Retrieved 7/15/2011, from: http://www.health.gov/communication/hlactionplan/pdf/Health_Literacy_Action_Plan.pdf
  3. Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006-483). Washington, DC: U.S. Department of Education.
  4.  Rudd, R. E., Anderson, J. E., Oppenheimer, S., & Nath, C., (2007). Health literacy: An update of public health and medical literature. In J. P. Comings, B. Garner, & C. Smith. (Eds.), Review of adult learning and literacy, 7, 175–204. Mahwah, NJ: Lawrence Erlbaum Associates.
  5. Friedland, R.B, & Summer, L. (1999). Demography Is Not Destiny. Washington, DC: National Academy on an Aging Society.
  6. Friedland, R.B. (1998). Life expectancy in the future: A summary of a discussion among experts. North American Actuarial Journal, 2(4), 1-14.
  7. Weiss, B.D. (1999). 20 Common Problems in Primary Care. New York: McGraw Hill, 468-481.
  8. Center for Health Care Strategies, Inc. (2005). Health Literacy Fact Sheet. The Commonwealth Fund and Pfizer Inc. Retrieved 10/25/11, from http://www.chcs.org/usr_doc/Health_Literacy_Fact_Sheets.pdf
  9. Martin, L.T., & Parker, R.M. (2011). Insurance expansion and health literacy. Journal of the American Medical Association. Published online August 9, 2011. Retrieved 10/25/11, from http://jama.amaassn.org/content/early/2011/08/05/jama.2011.1212.full
  10. American Medical Association. (2004). Health Literacy. AMA-MSS Community Service Committee. Retrieved 10/25/11, from http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/health-literacy.page
  11. Weiss, B.D. (2003). Health Literacy: A Manual for Clinicians. American Medical Association/American Medical Association Foundation, 7.
  12. Fox, S. (2006). Online Health Search 2006. Washington, DC: Pew Internet and American Life Project.
  13. Bernstein, A.B., Hing, E., Moss, A.J., Allen, K.F., Siller, A.B., & Tiggle, R.B. (2003). Health care in America: Trends in utilization. Hyattsville, Maryland: National Center for Health Statistics.
  14. Pawlak, R. (2005). Economic considerations of health literacy. Nursing Economics, 23, 170–180.
  15. Vitt, L.A., Siegenthaler, J.K., Siegenthaler, L., Lyter, D.M., & Kent, J. (2002). Consumer Health Care Finance and Education: Matters of Values (EBRI Issue Brief 241). Institute for Socio-Financial Studies, Employee Benefit Research Institute.
  16. Finkelstein, A., Taubman, S., Wright B, Bernstein M, Gruber J, Newhouse JP, & Allen, H., Baicker, K. (2011). The Oregon Health Insurance Experiment: Evidence from the First Year (NBER Working Paper No 17190). The Oregon Health Study Group.
  17. Student Health Insurance Services. (2011). Guide to Student Health Insurance and Healthcare at New York University, 2011-2012. New York University. Retrieved 10/25/11, from http://www.nyu.edu/shc/about/insurance.html
  18. Cunningham, P.J., Denk, C., & Sinclair, M. (2001). Do consumers know how their health plan works? Consumers tend to overestimate plan restrictions, especially regarding access to medical specialists. Health Affairs, 20(2), 159-166.
  19. Hibbard, J.H., & Jewett, J.J. (1997). Will quality report cards help consumers? Health Affairs, 16(3), 218-28.
  20. Isaacs, S. (1996). Consumers’ information needs: Results of a national survey. Health Affairs, 15(4), 31-41.
  21. Korcyk, S., & Witte, H. (2000). C.I.G. to managed health care. Upper Saddle River: NJ: Prentice Hall.
  22. Healthy People 2020. Health Communication and Information. Washington, DC: U.S. Department of Health and Human Services.
  23. Finkel, M.L. (1997). Evaluate and communicate health care benefits. Employee Benefits Journal, 22(4), 29-34.
  24. Jerussi, M, Savan, J. (2000). Educating employees on defined contribution health care: The time is eight for an employee-empowering approach. Benefits Quarterly, 16(4), 63-68.
  25. Emery, J, Cather, C. (2000.) Finally. Employers provide a focus to help health plans fashion full-scale e-strategies. Health Plan Advisor, 1-7.
  26. Goff, V. (2001). Consumer health care decision support: State of the art. Executive Brief. Washington, DC: National Health Care Purchasing Institute.
  27. Detmer, D., Bloomrosen, M., Raymond, B., & Tang, P. (2008). Integrated personal health records: Transformative tools for consumer-centric care. BMC Medical Informatics and Decision Making, 8, 45.
  28. New York University. (2010). Wellness expo evaluation.
  29. American College Health Association. American College Health Association - National College Health Assessment II: New York University Executive Summary Spring 2009. (2009). Hanover, MD: Author.
  30. American College Health Association. (2011). American College Health Association - National College Health Assessment II: New York University Executive Summary Spring 2011. Hanover, MD: Author.
  31. Rieh, S.Y., & Hilligoss, B. (2008). College students’ credibility judgments in the information-seeking process. Digital Media, Youth, and Credibility. The John D. and Catherine T. MacArthur Foundation Series on Digital Media and Learning. Cambridge, MA: The MIT Press, 49–72.
  32. Banas, J. (2008). A tailored approach to identifying and addressing college students’ online health information literacy. American Journal of Health Education, 39, 228–236.
  33. Neuhauser, L. (2001). Participatory Design for Better Interactive Health Communication: A Statewide Model in the U.S.A. The Electronic Journal of Communication. 11(3-4).
  34. U.S. Department of Health and Human Services. National Partnership for Action to End Health Disparities. Office of Minority Health. (2011, April). National stakeholder strategy for achieving health equity. Washington, DC: Author.
  35. Kimery, K.M., & Rinehart, S.M. (1998). Markets and constituencies: An alternative view of the marketing concept. Journal of Business Research, 43 (3), 117-24.
  36. U.S. Agency for International Development. (2002). Behavior change communication for HIV/AIDS: A strategic framework. Family Health International Institute for HIV/AIDS. Implementing Prevention and Care (IMPACT) Project.
  37. Centers for Disease Control and Prevention. (2009). What we know about health literacy. Health Communication and Marketing. National Center for Health Marketing. Washington, DC: U.S. Department of Health and Human Services.
  38. Adams, R.J., Stocks, N.P., Wilson, D.H., & Hill, C.L. (2009). Health literacy-a new concept for general practice. Australian Family Physician. 38 (3), 144-147.
  39. New York University. (2010). Wellness expo evaluation.
  40. American College Health Association. American College Health Association - National College Health Assessment II: New York University Executive Summary Spring 2009. (2009). Hanover, MD: Author.
  41. American College Health Association. (2011). American College Health Association - National College Health Assessment II: New York University Executive Summary Spring 2011. Hanover, MD: Author.


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