Child Health and School Readiness: The Significance of Health Literacy

Laurie Martin, ScD, MPH

Human Capital Research Collaborative Conference October 15, 2010

Overview

• Why health literacy?

• Current strategies to improve outcomes– Health, education, culture and society

• Major Impacts – National action plan to improve health literacy– National health education standards (NHES)

• Policy Implications

• Future Research

Health literacy defined

• Degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions

• Skills within health context

• Cultural and conceptual knowledge

• Influenced by clarity of health information

Societal costs of low health literacy

• Only 12% of population is proficient– Disproportionate number of racial and ethnic

minorities, immigrants, low education, elderly

• Cost to nation’s economy: challenging to estimate– Ballpark of $106-236 billion dollars annually– Does not include costs to child health and

school readiness

Potential pathways linking parental health literacy, child health, and school readiness

Child HealthSchool Readiness

& Academic Outcomes

Parental SES, health, and health

behaviors

Parental Health Literacy

Parental characteristics are related

Child HealthSchool Readiness

& Academic Outcomes

Parental SES, health, and health

behaviors

Parental Health Literacy

Parental health literacy affects child health

Child HealthSchool Readiness

& Academic Outcomes

Parental SES, health, and health

behaviors

Parental Health Literacy

Example

A two-year old is diagnosed with an inner ear infection and prescribed an antibiotic. Her mother understands that her daughter should that the medication twice a day. After carefully studying the label on the bottle and deciding that it doesn’t tell how to take the medicine, she fills a teaspoon and pours it into her daughter’s ear.

(Parker et al, 2003)

Parental health literacy as a moderator

Child HealthSchool Readiness

& Academic Outcomes

Parental SES, health, and health

behaviors

Parental Health Literacy

A life course perspective of health literacy

Parental health Literacy

Parental SES, health, and

health behaviors

Child health Academic outcomes

Child health literacy

Parental health literacy

Parental SES, health, and

health behaviors

Life courseChildren become parents

Education promotes child health literacy

• Data from NAEP highlight importance of educational system

• In 2009– One third of 4th and 8th graders proficient or

above in reading– 39% of 4th graders and 33% of 8th graders

proficient or above in math– 29% of 4th and 8th grade and 18% of 12th

graders scored proficient or above in science

Overview

• Why health literacy?

• Current strategies to improve outcomes– Health, education, culture and society

• Major Impacts – National action plan to improve health literacy– National health education standards (NHES)

• Policy Implications

• Future Research

Potential points for intervention

Parental health Literacy

Parental SES, health, and

health behaviors

Child health Academic outcomes

Child health literacy

Parental health literacy

Parental SES, health, and

health behaviors

Life courseChildren become parents

Health System Education System

Culture and Society

Current strategies to improve outcomes

• Health– Assessing health materials– Improving the transfer/retention of information– Assessing health care environments

• Education– Adult education– Coordinated school health program

• Culture and society– Communication– Identification of communities with lower health literacy

Overview

• Why health literacy?

• Current strategies to improve outcomes– Health, education, culture and society

• Major Impacts – National action plan to improve health literacy– National health education standards (NHES)

• Policy Implications

• Future Research

National Action Plan

• Outlines seven goals that contribute to a society that:– Provides everyone with access to accurate

and actionable health information– Delivers person-centered health information

and services– Supports lifelong learning and skills to

promote good health

Seven goals of the National Action Plan1. Develop and disseminate health and safety

information that is accurate, accessible, and actionable.

2. Promote changes in the health care system that improve health information, communication, informed decision making, and access to health services.

3. Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through the university level.

Seven goals of the National Action Plan

4. Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community.

5. Build partnerships, develop guidance, and change policies.

6. Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy.

7. Increase the dissemination and use of evidence-based health literacy practices and interventions.

National Health Education Standards

1. Students will comprehend concepts related to health promotion and disease prevention to enhance health.

2. Students will analyze the influence of family, peers, culture, media, technology, and other factors on health behaviors.

3. Students will demonstrate the ability to access valid information, products, and services to enhance health.

4. Students will demonstrate the ability to use interpersonal communication skills to enhance health and avoid or reduce health risks.

National Health Education Standards

5. Students will demonstrate the ability to use decision-making skills to enhance health.

6. Students will demonstrate the ability to use goal-setting skills to enhance health. 

7. Students will demonstrate the ability to practice health-enhancing behaviors and avoid or reduce health risks. 

8. Students will demonstrate the ability to advocate for personal, family, and community health.

Overview

• Why health literacy?

• Current strategies to improve outcomes– Health, education, culture and society

• Major Impacts – National action plan to improve health literacy– National health education standards (NHES)

• Policy Implications

• Future Research

Policies to improve parental health literacy

• Implement performance incentives for the use of universal precautions

• Deliver accurate, accessible, and actionable health information through early childhood programs

Policies to improve child health literacy

• Implement a unified curriculum across schools

• Incorporate examples of health skills and knowledge across all academic subjects

Overview

• Why health literacy?

• Current strategies to improve outcomes– Health, education, culture and society

• Major Impacts – National action plan to improve health literacy– National health education standards (NHES)

• Policy Implications

• Future Research

Future Research Directions

• Quantifying associations• Include parental health literacy as potential

explanatory factor in relation between parental characteristics and child outcomes

• Rigorously evaluate and identify evidence-based approaches in health and education system

• Health literacy measurement

Conclusions

• Health literacy sits at the intersection of health and education

• Health literacy, both of parent and child has important and lasting implications for child health and school readiness.

• Cross-system collaborations and strategies may be particularly effective in addressing issues related to limited health literacy, child health and academic success.