Page 32 - Small Animal Clinical Nutrition 5th Edition

32 Small Animal Clinical Nutrition

ment of personal skills and 3) critical health literacy, which
Table 3-1. Problems caused by inadequate health literacy.*
VetBooks.ir Improper use of medications is needed for personal and community empowerment
(Nutbeam, 1998).
Inappropriate use or no use of health services
Poor self-management of chronic conditions Understanding Health Literacy
Inadequate response in emergency situations
Poor health outcomes Health literacy includes more than simply obtaining informa-
Lack of self-efficacy and self-esteem tion. Health literacy embraces writing, numeracy, listening,
Financial drain on individuals and society speaking and conceptual knowledge (IOM, 2004). Health lit-
*Adapted from Zarcadoolas C, Pleasant AF, Greer DS.
Advancing Health Literacy. San Francisco, CA: Jossey-Banks, eracy emerges when expectations, preferences and skills of indi-
2006. viduals seeking health information meet equivalent goals of
those providing information and services (IOM, 2004).
Education, language and culture mediate health literacy skills
(IOM, 2004). Equally important are the communication and
Table 3-2. Examples of skills needed for health.* assessment skills of health care professionals. Furthermore,
their patients must navigate the media, marketplace and gov-
Promote and protect health and prevent disease ernmental agencies to obtain health information (IOM, 2004).
Understand, interpret and analyze health information
Apply health information over a variety of life events and situa- Even people with strong literacy skills may have trouble
tions obtaining, understanding and using health information; for
Navigate the health care system example, an accountant may not know when to schedule a pap
Actively participate in encounters with health care professionals
Understand and give consent smear and a chef may be unable to prepare health conscious
Understand and advocate for rights meals (IOM, 2004).
*Adapted from IOM. (Institute of Medicine.) Health Literacy: A As mentioned above,90 million adults (47% of the adult pop-
Prescription to End Confusion. Washington, DC: National
Academies Press, 2004; 1-322. ulation) may lack the literacy skills to effectively use the U.S.
health care system (IOM, 2004). The majority of these adults
were born in the U.S. and speak English. Literacy levels are
lower among elderly persons, those who have lower educational
as necessary as appropriate medicine and surgery. It is a sober- levels,those who are poor,minority populations and groups with
ing thought to consider that the number of pet deaths attrib- limited English proficiency such as recent immigrants (IOM,
utable to poor communication may meet or exceed surgical or 2004). The gap between knowledge and practice is widened by
anesthetic-related deaths. inadequate health literacy. People who lack an understanding of
Because there is little in the way of insights about this prob- health care usually present with more advanced disease, receive
lem in veterinary medicine, issues about the human health lit- fewer preventive care services and have poorer health outcomes
eracy crisis will be discussed. Readers should associate these (IOM, 2004). As one example, diabetics with poor health liter-
data to the client-pet-veterinary and veterinary team interface acy were more likely than patients with adequate health literacy
and challenge themselves to make a concerted effort to to have poor glycemic control and reported more retinopathies
enhance communication skills to better care for the pets and (Schillinger et al, 2002).
people they serve. In its report Healthy People 2010, the U.S. Department of
Health and Human Services included improved consumer
Definitions health literacy as Objective 11-2, and identified health litera-
Health literacy may be defined as “the degree to which individ- cy as an important component of health communication,
uals have the capacity to obtain, process and understand basic medical product safety and oral health. The 2003 Coalition
health information and services needed to make appropriate for Allied Health Leadership team completed a national sur-
health decisions” (Ratzan and Parker, 2000; Healthy People vey of allied health professionals and educators to assess
2010). A 1999 report from the Council on Scientific Affairs of awareness and needs concerning health literacy. Approx-
the American Medical Association refers to functional health imately one-third of all respondents were unaware of the
literacy as “the ability to read and comprehend prescription bot- issues surrounding health literacy, or that health literacy
tles, appointment slips and other essential health-related mate- resources were available; denied knowledge of an impact of
rials” (AMA, 1999). health literacy on patient care for their specific profession or
Other proposed definitions include: had no institutional policy or goals to address health literacy.
• Health literacy is a constellation of skills,including the abil- The article states that inadequate health literacy adversely
ity to perform basic reading and numerical tasks required to affects health care outcomes and the quality of life of 90 mil-
function in the health care environment (AMA Ad Hoc lion Americans. The cost to the health care system is $73 bil-
Committee). lion annually (Health Literacy Survey, 2004).
• Health literacy has three levels: 1) functional health litera- “Literacy” provides the skills that enable individuals to
cy, which refers to the communication of information, 2) understand and communicate health information and con-
interactive health literacy, which deals with the develop- cerns. As mentioned above, educators do not associate literacy