# Presentation: 658199

## Healthy People 2010 Focus Area 11:Health CommunicationProgress ReviewApril 19, 2007

## More than 1 in 3 adults (77 million people) lack sufficient health literacy to
Interpret an OTC drug label
Know when a child should receive a vaccine
Use a BMI chart
Internet access is improving, but disparities persist
Patient perception of poor provider communication is associated with
Non-English preference
Public insurance or no insurance
Less education 

**More than 1 in 3 adults (77 million people) lack sufficient health literacy to**
**Interpret an OTC drug label**
**Know when a child should receive a vaccine**
**Use a BMI chart**
**Internet access is improving, but disparities persist**
**Patient perception of poor provider communication is associated with**
**Non-English preference**
**Public insurance or no insurance**
**Less education **

## Objective Status

**11-5.   ****	****  Centers for excellence in health communication**

**Target met or exceeded**

**Improving**

**11-1.   ****	****  Internet access in the home**
**11-6c.****	****  Healthcare provider shows respect**
**11-6d.  ****	****  Healthcare provider spends enough time**

**Newly measurable***

**11-2.****	**** Health literacy**
**11-3.****	**** Evaluation of HHS campaigns**
**11-4.****	**** Health Web sites disclosing quality-related information**

- * Newly measurable objectives have only baseline data.

**Little or no change**
**11-6a. ****	****  Healthcare provider listens carefully**
**11-6b. ****	****  Healthcare provider explains things so that patients can understand**

**Objective Status**

## CDC-funded
U of Connecticut
U of Georgia
Harvard Medical School
U of Washington

**Centers for Excellence in ****Health Communication**

**CDC-funded**
- U of Connecticut
- U of Georgia
- Harvard Medical School
- U of Washington

**NCI-funded**
- U of Michigan
- U of Pennsylvania
- St. Louis U
- U of Wisconsin

- Source: National Cancer Institute (NCI), National Institutes of Health (NIH),
- U.S. Department of Health and Human Services.

**Obj. 11-5**

**Centers are expected to**
**Contribute to the knowledge base**
**Train professionals **
**Disseminate theories, concepts, and methods**
**4 Centers in 2003, 8 in 2006   (target 6)**

## Internet Access in the Home

**Obj. 11-1**

- I = 95% confidence interval.  Data are for adults aged 18 and over.
- Black and white exclude persons of Hispanic origin.  Sources: National Household Education Survey (NHES), U.S. Department of Education and Current Population Survey (CPS), U.S. Department of Commerce, Bureau of the Census.

**Percent**

**Asian/**
**Pacific Islander**

**White**

**2001**

**2003**

**Internet Access in the Home**

**American Indian/**
**Alaska Native**

**Hispanic**

**2010 Target: 80**

**Black**

**Total**

## Internet Access in the Home

**Obj. 11-1**

- I = 95% confidence interval.  Data are for adults age 18 years and over.   *Education level is for adults age 25 years and over. †Data for persons with disabilities were collected only in 2001.
- Source: National Household Education Survey (NHES), U.S. Department of Education.

**Percent**

**2001**

**2003**

**Internet Access in the Home**

**2010 Target: 80**

**Total**

**Education***

## Health Web Sites That Disclose 

**Target: 64**

**Target: 80**

- I = 95% confidence interval. *Data are statistically unreliable.
- Source: Office of Disease Prevention and Health Promotion, “Estimating the Proportion of Health-Related
- Websites Disclosing Information That Can Be Used To Assess Their Quality.”  Mathematica Policy Research, Inc.
- May 6, 2006.

**Obj. 11-4 a-g**

**User feedback**

**Purpose**

**Target: 19**

**Identity of sponsor**

**Privacy of personal information**

**Editorial policy**

**Update date**

**<1%***

**Target: 10**

**<1%***

**Target: 40**

**Percent**

**Health Web Sites That Disclose **
**Information Related to **
**the Web Site’s Quality, 2006**

## Health Web Sites That Disclose 

**Information Related to**
**the Web Site’s Quality, 2006**

**Target: 10**

**Target: 64**

**Target: 80**

- I = 95% confidence interval. *Data are statistically unreliable.
- Source: Office of Disease Prevention and Health Promotion, “Estimating the Proportion of Health-Related
- Websites Disclosing Information That Can Be Used To Assess Their Quality.”  Mathematica Policy Research, Inc.
- May 6, 2006.

**Obj. 11-4 a-g**

**User feedback**

**Purpose**

**Target: 19**

**Identity of sponsor**

**Privacy of personal information**

**Editorial policy**

**Update date**

**3 or more criteria**

**<1%***

**Target: 10**

**<1%***

**Target: 29**

**Target: 40**

**Percent**

## Study of 37 (out of 117) campaigns from 2002 to 2005

Research conducted during program development (Formative)
		35 of 37 or 95% (target 100%)

Documentation and study of campaign components during implementation (Process) 
		30 of 37 or 81% (target 89%)

Measurement of campaign impact (Outcome) 
		22 of 37 or 59% (target 65%)

**HHS-Sponsored ****Health Communication Campaigns ****That Include Research and Evaluation**

**Study of 37 (out of 117) campaigns from 2002 to 2005**
**Research conducted during program development (Formative)**
**	****	****35 of 37 or 95% (target 100%)**
**Documentation and study of campaign components during implementation (Process) **
**	****	****30 of 37 or 81% (target 89%)**
**Measurement of campaign impact (Outcome) **
**	****	****22 of 37 or 59% (target 65%)**

- Source: Office of Disease Prevention and Health Promotion, Office of the Secretary,
- U.S. Department of Health and Human Services.

**Obj. 11-3 a-c**

## Patient Perception of Positive

**Obj. 11-6 a-d**

- I = 95% confidence interval.  Data are for adults age 18 years and over.  Percent of patients who responded “always” to questions on listening carefully, explaining things, showing respect, and spending enough time.
- Source: Medical Expenditure Panel Survey (MEPS), Agency for Healthcare Research and Quality (AHRQ),
- U.S. Department of Health and Human Services.

**Percent**

**Explain **
**things**

**Show**
** ****respect**

**2001**

**2004**

**Patient Perception of Positive**
**Provider Communication Skills **

**Target: 64**

**Spend enough **
**time**

**Listen **
**carefully**

**Target: 65**

**Target: 65**

**Target: 52**

## Patient Perception of Poor

- I = 95% confidence interval.  Data are for adults age 18 years and over.  Percent of patients who answered “sometimes” or “never” to questions on listening carefully, explaining things, showing respect, and spending enough time.  Persons of Hispanic origin may be any race.  Respondents were asked to select one or more races.  Data for the single race categories are for persons who reported only one racial group.  American Indian includes Alaska Natives. Source: Medical Expenditure Panel Survey (MEPS), Agency for Healthcare Research and Quality (AHRQ),
- U.S. Department of Health and Human Services.

**Percent**

**Asian**

**American Indian**

**Male**

**Total**

**Hispanic**

**Black**

**White**

**Female**

**Patient Perception of Poor**
**Provider Communication Skills, 2003**

## Patient Perception of Poor

- I = 95% confidence interval.  Data are for adults age 18 years and over.  *Health insurance data are for adults age 18 to 64 years.  Percent of patients who answered “sometimes” or “never” to questions on listening carefully, explaining things, showing respect, and spending enough time.  Source: Medical Expenditure Panel Survey (MEPS), Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services.

**Percent**

**English**

**Private**

**High school**

**Total**

**Other**

**None**

**Public**

**Less than high school**

**Patient Perception of Poor**
**Provider Communication Skills, 2003**

**Some college**

**Language preference**

**Health insurance***

**Education**

## Proficient  (12%) 
Finding information required to define a medical term by searching a complex document, such as a drug label. 
25 million people aged 16 and over

Intermediate  (53%) 
Finding the age range for a particular vaccine from a childhood vaccines chart. 
114 million people aged 16 and over

Basic  (22%)
Giving two reasons why a person with no symptoms of a specific disease should be tested for the disease, based on information in a clearly written pamphlet. 
47 million people aged 16 and over

Below Basic  (14%)
Identifying what is permissible to drink before a medical test, based on a set of short instructions. 
30 million people aged 16 and over

**The Four Levels of Health Literacy, 2003**

***Proficient ***** **(12%)** **
- Finding information required to define a medical term by searching a complex document, such as a drug label.
- 25 million people aged 16 and over
***Intermediate  ***(53%)
- Finding the age range for a particular vaccine from a childhood vaccines chart.
- 114 million people aged 16 and over
***Basic  ***(22%)
- Giving two reasons why a person with no symptoms of a specific disease should be tested for the disease, based on information in a clearly written pamphlet.
- 47 million people aged 16 and over
***Below**** ****Basic***  (14%)
- Identifying what is permissible to drink before a medical test, based on a set of short instructions.
- 30 million people aged 16 and over

- Percentages do not total 100 because of rounding.
- Source: National Assessment of Adult Literacy (NAAL), National Center for Education Statistics (NCES),
- U.S. Department of Education.

**Obj. 11-2**

## Percent Distribution of 

- Percentages do not total 100 because of rounding.
- The black and white categories exclude persons of Hispanic origin.  Data are for persons age 16 years and over.
- Source: National Assessment of Adult Literacy (NAAL), National Center for Education Statistics (NCES),
- U.S. Department of Education.

**Obj. 11-2**

**Hispanic**

**Percent Distribution of **
**Health Literacy Level, 2003**

**0                20               40               60               80            100 **

**Percent**

**Asian/****Pacific Islander**

**White**

**Black**

**American Indian/****Alaska Native**

**Total**

**Below Basic**

**Basic**

**Intermediate**

**Proficient**

**14% **

**22% **

**53% **

**12%**** **

## Below Basic Health Literacy, 2003

**Obj. 11-2b**

**0         ****	****10****	**** 20            30           40            50          60**

**2010 Target: TBD**

**Total**
**Persons with disabilities**
**Persons w/o disabilities**
**18-24 years**
**25-44 years**
**45-64 years**
**65+ years**
**Less than high school**
**High school**
**At least some college**

***Below Basic***** Health Literacy, 2003**

**     **= 95% confidence interval.**  **Data for persons with disabilities are for persons age 16 years and over.  Education data are for persons age 25 years and over.  Source: National Assessment of Adult Literacy (NAAL), National Center for Education Statistics (NCES), U.S. Department of Education.

- I

**Percent**

## Data sources identified for all objectives 
Funding of future data collection is uncertain
For some objectives, smaller racial/ethnic groups lack reliable data
Data needed on link between provider communication and patient outcome

**Data sources identified for all objectives **
**Funding of future data collection is uncertain**
**For some objectives, smaller racial/ethnic groups lack reliable data**
**Data needed on link between provider communication and patient outcome**

## Progress review data and slides

**Progress review data and slides**
**are available on the web at:**

**http://www.cdc.gov/nchs/hphome.htm**