Health Literacy

Health LiteracyHealth Literacy in Canada:
A Healthy Understanding

February 20, 2008
What is health literacy?

The Canadian Public Health Association defines health literacy as:

“Skills to enable access, understanding and use of information for health”

These literacy skills are used for a wide range of daily tasks, such as making healthy lifestyle choices, finding and understanding health and safety information, and locating proper health services.

Report resources

How are Canadians doing?

Not very well. As reported by CCL in 2007, the majority of adult Canadians (60%) do not have the necessary skills to manage their health adequately.

For an overview of health-literacy levels in Canada, please consult the interactive map available through the links below.

 

Health Literacy Map 2008

Interactive map of health literacy:   Using the health literacy map   l   Canada   l   Health regions   l   British Columbia   l   Prairies   l   Ontario   l   Quebec   l   Atlantic region   l   North

What's new in this report?

This report examines the relationship between levels of health literacy and health outcomes (e.g., diabetes). It also outlines how certain characteristics, such as education and age, can affect health literacy.

What are the key findings?
  • Daily reading is the strongest factor in predicting higher levels of health literacy.
  • The simple act of reading every day is associated with improved health-literacy scores: 38% higher for those aged 16–65, and 52% higher for those of 66 years, and older.
  • Canadians with the lowest health-literacy skills are 2.5 times more likely to report being in fair or poor health as those with the highest skill levels, even after correcting for factors such as age, education and gender.
  • The prevalence of diabetes increases significantly as health literacy decreases. A similar relationship, although not as strong, is found for high blood pressure (see chart below).
  • Health literacy is more complex than general literacy. Mastering health-literacy tasks requires the use of more than one literacy skill—prose, document and numeracy—often simultaneously.
  • In terms of health literacy, the three most vulnerable populations are seniors, immigrants and the unemployed.

 

Prevalence of diabetes, by average health-literacy level, by health region

Why is health literacy important?

Improved health literacy may, for example, reduce the prevalence of diabetes in the population and possibly improve its management. In addition to enhancing the quality of life for many people, this could result in significant cost savings for the health-care system.

In 2000, approximately 1.4 million diabetes patients used $4.66 billion in health-care costs. In 2016, there will be an estimated 2.4 million diabetes patients with an estimated cost of $8.14 billion. (Source: Canadian Journal of Diabetes)

Test your health literacy

Can you correctly answer this example question?

“Imagine your child is 11 years old and weighs 85 pounds. According to the chart below, how many 80 mg tablets of Tempra can you administer to your child in a 24-hour period?”

Health literacy: Tempra example

Note: This example is reprinted with permission.
Source: Rudd, R., I. Kirsch  and K. Yamamoto. Literacy and Health in America (New Jersey: Center for Global Assessment, Policy Information Center, Research and Development, Educational Testing Service, 2004)

LITERACY LEVELS DEFINED
The Organisation for Economic Co-operation and Development (OECD) defines the following five levels of literacy:

Level 1Very poor literacy skills
Level 2A capacity to deal only with simple, clear material involving uncomplicated tasks
Level 3Adequate to cope with the demands of everyday life and work in an advanced society
Levels 4 and 5 Strong skills.

Proficiency scores on the health literacy scale were estimated using an Item Response Theory (IRT) statistical model. Scores ranged from 0 to 500 and are characterized using five levels that capture the progression of complexity and difficulty. Level 1 represents the lowest level of proficiency and Level 5 the highest.

Summary of the methodology:

The data for the local area maps is from the 2003 International Adult Literacy and Life Skills Survey (IALSS) conducted by Statistics Canada and the Organisation for Economic Co-operation and Development, and the 2001 Canadian Census. The maps were produced using a mapping technique developed by the Canadian Research Institute for Social Policy (CRISP). The CRISP mapping technique estimates a score on an outcome variable for all Canadian citizens, based on the best available information for each individual, and then displays the resulting scores on provincial or local area maps.

The approach uses the 2001 Canadian census data to create a file for each province that includes a “pseudo-record” for every individual in the province, based on the distribution of people by gender and age in each Dissemination-Area (DA). An estimate of a person’s outcome (in this case their “health literacy” score) for all people in the pseudo-record file is estimated using multilevel multiple regression techniques, based on the following data:

  1. information at the individual level from a Statistics Canada survey (in this case the IALSS) about how well other people of the same age and gender scored in the person’s DA, and in other DAs in their local area (out to three levels of contiguity), and
  2. information at the DA-level on the average outcome scores and the demographic characteristics of all DAs in the province. For each estimate we add an error term based on the regression results of the multilevel model. Results are then aggregated to the DA level and used for mapping.  

 

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