Diversity

Committee on National Statistics. Eliminating Health Disparities: Measurement and Data Needs. The National Academies Press: Washington DC, 2004.    

Acculturation: Critical Literature review

NIH Library of Medicine Health Literacy Bibliography

"Identifying Medicare Beneficiaries With Poor Health Literacy Skills: Is A Short Screening Index Feasible?" by Judith Hibbard, Dr.P.H., Jessica Greene, and Martin Tusler, University of Oregon (#2005-01, 22 pages).

This paper represents a first step toward the development of a screening tool that could be applied in a clinical setting or a Medicare counseling center to identify people who need extra assistance in following instructions, using information, and making choices. The findings indicate that the approach is feasible, and the results suggest that additional research with larger, more diverse populations is warranted.

"How Much Do Health Literacy and Patient Activation Contribute to Older Adults' Ability to Manage Their Health?" by Jessica Greene, Judith Hibbard, and Martin Tusler, University of Oregon (#2005-05, 24 pages).

The authors were engaged to conduct this study to determine the relationships among certain variables so that Medicare counselors, information intermediaries, clinicians, and others can improve their education strategies by providing appropriate, skill-related interventions to Medicare patients on the basis of their health literacy and level of patient activation. We believe this is the first study to assess these relationships.

The findings from this study are timely, as the Medicare Prescription Drug, Modernization, and Improvement Act will require a massive educational effort to help orient people on Medicare to the program's new features, including the prescription drug benefit and the private health plan models that will soon be available.

The study finds that patient activation and health literacy positively influence the skills and behaviors older adults need to effectively manage their health. However, the two factors affect different health-related outcomes. Health literacy positively influences Medicare decision making. Patient activation, on the other hand, has a greater influence on one's engagement in health-care-related, healthy, and chronic illness self-management behaviors.