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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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HEALTH
LITERACY AND
OLDER ADULTS

RESHAPING THE
LANDSCAPE

PROCEEDING OF A WORKSHOP

Joe Alper, Rapporteur

Roundtable on Health Literacy

Board on Population Health and Public Health Practice

Health and Medicine Division

images

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

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

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 Medical Center; Northwell Health; Office of Disease Prevention and Health Promotion (HHSP23337043); Pfizer Inc.; 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: 978-0-309-47946-2
International Standard Book Number-10: 0-309-47946-0
Digital Object Identifier: https://doi.org/10.17226/25188

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Health literacy and older adults: Reshaping the landscape: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25188.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

Image

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. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

Image

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. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

PLANNING COMMITTEE ON HEALTH LITERACY AND OLDER ADULTS: RESHAPING THE LANDSCAPE1

AMY K. CHESSER, Assistant Professor, Wichita State University

ANNA CHODOS, Assistant Professor, University of California, San Francisco, School of Medicine

DEIDRA C. CREWS, Associate Vice Chair for Diversity and Inclusion and Associate Professor of Medicine, Johns Hopkins University School of Medicine

LINDA HARRIS, Director, Division of Health Communication and eHealth, Office of Disease Prevention and Health Promotion, Department of Health and Human Services

SHANNAH KOSS, President, Koss on Care, LLC

TERRI ANN PARNELL, Principal and Founder, Health Literacy Partners

RIMA RUDD, Senior Lecturer on Health Literacy, Education, and Policy, Harvard T.H. Chan School of Public Health

YOLANDA TAYLOR BRIGNONI, Integrated Strategic Communications Director, AARP

JENNIFER WOLFF, Professor of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health

___________________

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. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

ROUNDTABLE ON HEALTH LITERACY1

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

ANNLOUISE R. ASSAF, Enterprise Benefit Risk Medical Director, Pfizer Inc.

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

AMY A. CLARK, Director, Cultivating Health Communities, Aetna Foundation

GEMIRALD P. 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 A. 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

LISA FITZPATRICK, Senior Medical Director, DC Department of Health Care Finance; and Professorial Lecturer, George Washington University Milken Institute School of Public Health

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

LINDA HARRIS, Director, Division of Health Communication and eHealth, Office of Disease Prevention and Health Promotion, Department of Health and Human Services

NICOLE HOLLAND, Assistant Professor and Director of Health Communication, Education, and Promotion, Tufts University School of Dental Medicine

JOAN KELLY, Chief Patient Experience Officer, New York University Langone Medical Center

___________________

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. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

ELLEN M. MARKMAN, Lewis M. Terman Professor of Psychology, Stanford University

MICHAEL M. McKEE, Assistant Professor of Family Medicine, University of Michigan Medical School

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

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

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

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

STEVEN RUSH, Director, Health Literacy Innovations, UnitedHealth Group

OLAYINKA SHIYANBOLA, Assistant Professor, Division of Social and Administrative Sciences, Univeristy of Wisconsin–Madison School of Pharmacy

VANESSA SIMONDS, Assistant Professor, Community Health, Montana State University

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

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. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

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:

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 NANCY FUGATE WOODS, University of Washington. She 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. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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This page intentionally left blank.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

Acknowledgments

The sponsors of the Roundtable on Health Literacy made it possible to plan and conduct the workshop on Health Literacy and Older Adults: Reshaping the Landscape, which this proceedings summarizes. Federal sponsors from the Department of Health and Human Services are the 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; Pfizer Inc.; and UnitedHealth Group.

The workshop presentations were interesting and stimulated much discussion, and the Roundtable on Health Literacy would like to thank each of the speakers and moderators for their time and effort. Speakers and moderators were Amy K. Chesser, Deidra Crews, Z. Colette Edwards, Susan Goodman, Lisa Gualtieri, Shannah Koss, Terri Ann Parnell, Bernard M. Rosof, Rima Rudd, Nora Super, Yolanda Taylor Brignoni, Stephen B. Thomas, Anne Tumlinson, Jennifer Wolff, and Mary Ann Zimmerman.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

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Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×

Acronyms and Abbreviations

AAA Area Agency on Aging
BRFSS Behavioral Risk Factor Surveillance System
EHR electronic health record
HAIR Health Advocates In-Reach and Research
HIPAA Health Insurance Portability and Accountability Act
LTSS long-term services and supports
n4a National Association of Area Agencies on Aging
REALM Rapid Estimate of Adult Literacy in Medicine
S-TOFHLA Short Test of Functional Health Literacy in Adults
TOFHLA Test of Functional Health Literacy in Adults
Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
×
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Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25188.
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Adults age 65 and older make up the fastest-growing segment of the U.S. population. At the same time, the complexity of health care delivery continues to grow, creating challenges that are magnified for older adults, given that age is one of the highest correlates of low health literacy. This creates a shared obligation between health care and the health care team to use the principles, tools, and practices of health literacy so that patients and families of older adults can more easily navigate discussions related to chronic disease, polypharmacy, long-term care, palliative care, insurance complexities, the social determinants of health, and other factors that create challenges for older adults, particularly among underserved populations nationwide.

To gain a better understanding of the health communication challenges among older adults and their professional and family caregivers and how those challenges affect the care older adults receive, the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Health Literacy convened a 1-day public workshop featuring presentations and discussions that examined the effect of low health literacy on the health of older adults. This publication summarizes the presentations and discussions from the workshop.

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