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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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Building the Case for
Health Literacy

PROCEEDINGS OF A WORKSHOP

Joe Alper, Rapporteur

Roundtable on Health Literacy

Board on Population Health and Public Health Practice

Health and Medicine Division

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THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by contracts between the National Academy of Sciences and AbbVie Inc.; Aetna Foundation; American Dental Association; Bristol-Myers Squibb; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Media; Health Literacy Partners; Health Resources and Services Administration (HHSH25034011T); Humana; Institute for Healthcare Advancement; Merck Sharp & Dohme Corp.; National Library of Medicine; New York University Langone Health System; Northwell Health; Office of Disease Prevention and Health Promotion (HHSP23337043); and UnitedHealth Group. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-47429-0
International Standard Book Number-10: 0-309-47429-9
Digital Object Identifier: https://doi.org/10.17226/25068

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Building the case for health literacy: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25068.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
×

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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

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The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
×

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Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
×

PLANNING COMMITTEE ON BUILDING THE CASE FOR HEALTH LITERACY1

SUSAN BOCKRATH (Chair), Health Literacy Nebraska

LORI HALL, Director of Health Literacy, Eli Lilly and Company

STANTON HUDSON, Associate Director, University of Missouri Center for Health Policy

LAURIE MYERS, Global Health Literacy Director, Merck Sharp & Dohme Corp.

LAURA K. NOONAN, Director, Center for Advancing Pediatric Excellence, Levine Children’s Hospital at Carolinas Medical Center

AUDREY RIFFENBURGH, President, Health Literacy Connections

BERNARD M. ROSOF, Chief Executive Officer, Quality HealthCare Advisory Group, LLC, and Professor of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

STEVEN RUSH, Director, Health Literacy Innovations Program, UnitedHealth Group

MICHAEL VILLAIRE, President and Chief Executive Officer, Institute for Healthcare Advancement

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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ROUNDTABLE ON HEALTH LITERACY1

BERNARD M. ROSOF (Chair), Chief Executive Officer, Quality HealthCare Advisory Group, LLC, and Professor of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

WILMA ALVARADO-LITTLE, Associate Commissioner, New York State Department of Health, and Director, Office of Minority Health and Health Disparities Prevention

SUZANNE BAKKEN, Alumni Professor of Nursing and Professor of Biomedical Informatics, Columbia University

CINDY BRACH, Senior Health Policy Researcher, Agency for Healthcare Research and Quality

GEMIRALD DAUS, Public Health Analyst, Office of Health Equity, Health Resources and Services Administration

TERRY C. DAVIS, Professor of Medicine and Pediatrics, Louisiana State University Health Sciences Center

CHRISTOPHER DEZII, Director, Healthcare Quality and Performance Measures, Bristol-Myers Squibb

JENNIFER DILLAHA, Medical Director for Immunizations, Medical Advisor, Health Literacy and Communication, Arkansas Department of Health

JAMES DUHIG, Head, Risk Communication and Behavioral Systems, Office of Patient Safety, AbbVie Inc.

ALICIA FERNANDEZ, Professor of Clinical Medicine, Department of Medicine, Division of General Internal Medicine, University of California, San Francisco

LAURIE FRANCIS, Executive Director, Partnership Health Center

LORI HALL, Director of Health Literacy, Global Medical Strategy and Operations, Eli Lilly and Company

LINDA HARRIS, Director, Division of Health Communication and eHealth Team, U.S. Department of Health and Human Services

JOAN KELLY, Chief Patient Experience Officer, New York University Langone Health System

LAURIE MYERS, Global Health Literacy Director, Merck Sharp & Dohme Corp.

CATINA O’LEARY, President and Chief Executive Officer, Health Literacy Media

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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MICHAEL K. PAASCHE-ORLOW, Professor of Medicine, Boston University School of Medicine

TERRI ANN PARNELL, Principal and Founder, Health Literacy Partners

KIM PARSON, Strategic Consultant, Proactive Care Strategies, Humana

KAVITA PATEL, Managing Director for Clinical Transformation and Delivery, The Brookings Institution

ANDREW PLEASANT, Senior Advisor on Health Literacy Interventions, Research, and Evaluation, Health Literacy Media

LINDSEY A. ROBINSON, Thirteenth District Trustee, American Dental Association

STACEY ROSEN, Associate Professor of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, and Vice President, Women’s Health, The Katz Institute for Women’s Health

RIMA RUDD, Senior Lecturer on Health Literacy, Education, and Policy, Harvard School of Public Health

STEVEN RUSH, Director, Health Literacy Innovations, UnitedHealth Group

MICHAEL VILLAIRE, Chief Executive Officer, Institute for Healthcare Advancement

EARNESTINE WILLIS, Kellner Professor in Pediatrics, Medical College of Wisconsin

AMANDA J. WILSON, Head, National Network Coordinating Office, National Library of Medicine

MICHAEL S. WOLF, Professor, Medicine and Learning Sciences, Associate Division Chief, Research Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University

WINSTON F. WONG, Medical Director, Disparities Improvement and Quality Initiatives, Kaiser Permanente

Consultant

RUTH PARKER, Professor of Medicine, Pediatrics, and Public Health, Emory University School of Medicine

Health and Medicine Division Staff

LYLA M. HERNANDEZ, Senior Program Officer

MELISSA G. FRENCH, Program Officer

ALEXIS WOJTOWICZ, Senior Program Assistant

ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

JULIE MCKINNEY, Exceptional Lives, Inc.

GREG O’NEILL, Christiana Care Health System

HELEN OSBORNE, Health Literacy Consulting

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by HUGH H. TILSON, University of North Carolina. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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Acknowledgments

The sponsors of the Roundtable on Health Literacy made it possible to plan and conduct the workshop Building the Case for Health Literacy, which this publication summarizes. Federal sponsors from the U.S. Department of Health and Human Services are the Agency for Healthcare Research and Quality, Health Resources and Services Administration, National Library of Medicine, and Office of Disease Prevention and Health Promotion. Nonfederal sponsorship was provided by AbbVie Inc.; Aetna Foundation; American Dental Association; Bristol-Myers Squibb; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Media; Health Literacy Partners; Humana; Institute for Healthcare Advancement; Merck Sharp & Dohme Corp.; New York University Langone Medical Center; Northwell Health; and UnitedHealth Group.

The Roundtable on Health Literacy would like to thank each of the speakers and moderators for their time and effort. Speakers and moderators were Thomas K. Bauer, Chris Carlson, Jennifer Dillaha, Laurie Francis, Cathryn Gunther, Lori K. Hall, Stanton Hudson, Laura K. Noonan, Jennifer Pearce, Martin Ratermann, Audrey Riffenburgh, R. V. Rikard, Bernard M. Rosof, Lawrence G. Smith, and Christopher R. Trudeau.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25068.
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Acronyms and Abbreviations

ACA

Patient Protection and Affordable Care Act

ADH

Arkansas Department of Health

AHRQ

Agency for Healthcare Research and Quality

CANDOR

Communication and Optimal Resolution

CMS

Centers for Medicare & Medicaid Services

EHR

electronic health record

FQHC

federally qualified health center

HCAHPS

Hospital Consumer Assessment of Healthcare Providers and Systems

HHS

U.S. Department of Health and Human Services

HIPAA

Health Insurance Portability and Accountability Act

PCORI

Patient-Centered Outcomes Research Institute

VA

U.S. Department of Veterans Affairs

WIC

Special Supplemental Nutrition Program for Women, Infants, and Children

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The field of health literacy has evolved from one focused on individuals to one that recognizes that health literacy is multidimensional. While communicating in a health literate manner is important for everyone, it is particularly important when communicating with those with limited health literacy who also experience more serious medication errors, higher rates of hospitalization and use of the emergency room, poor health outcomes, and increased mortality. Over the past decade, research has shown that health literacy interventions can significantly impact various areas including health care costs, outcomes, and health disparities.

To understand the extent to which health literacy has been shown to be effective at contributing to the Quadruple Aim of improving the health of communities, providing better care, providing affordable care, and improving the experience of the health care team, the National Academies of Sciences, Engineering, and Medicine convened a public workshop on building the case for health literacy. This publication summarizes the presentations and discussions from the workshop, and highlights important lessons about the role of health literacy in meeting the Quadruple Aim, case studies of organizations that have adopted health literacy, and discussions among the different stakeholders involved in making the case for health literacy.

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