In a new endeavor, made possible by the Kellogg Health of the Public Fund, the Institute of Medicine (IOM) has partnered with the Academy for Educational Development (AED) to assess and address health literacy at a community level.

The work of this project was conducted using information from the IOM report titled Health Literacy: A Prescription to End Confusion. William Smith, a committee member on the Health Literacy report and Executive Vice President of AED was responsible for introducing the project and working with IOM staff to initiate the activity.

Using a proven tool called Community YouthMapping (CYM), a team of youth in Pinellas County, Florida and Harlem, New York are trained as health literacy "mappers." The youth identify places and institutions within their community where citizens, educators and health professionals can go to get help with their health literacy needs. CYM, as defined by AED, is "the process of involving and engaging youth and adults in the collection of baseline information" on health literacy resources in a given community.

In the selected cities, youth help determine:

• How many people in the community have problems with health literacy;
• Where the average person can go to get help understanding their health paperwork;
• If physicians and hospitals have support in creating health literate materials;
• If pharmacies have programs to help people understand their medications;
• If written materials are tested in the community; and
• If adult literacy programs include health literacy examples?

What is Health Literacy? 

Health literacy is the ability to find, understand and use health information and services to make appropriate health decisions and act on health information. It is more than reading and writing, it also includes listening, speaking clearly, calculating basic math, using basic measures, and bridging cultural barriers. To date, no programs have focused on health literacy at the community level.

Why Now?

More than 300 studies indicate that health-related materials far exceed the average reading ability of U.S. adults and indicate that 90 million adults in America may lack the ability to effectively use the U.S. health system. The majority are native-born English speakers, although non-English speakers and the elderly are disproportionably affected.

Health literacy is not only a characteristic of a patient or family member.  Physicians, nurses, receptionists, signage, consent forms, and pill bottles can all be demonstrated to have "low health literacy."   Examples of this include:

• Physicians unable to communicate instructions to their patients;
• Individuals unable to read or understand instructions on medication packaging;
• Patients unable to interpret medical consent forms; or
• Signs displayed in hospitals or doctors offices that use words not commonly understood by the general public

Who can help make a change in the community?

• Adult education classes can add health content to their adult literacy classes;
• Elder organizations can help senior citizens understand their medications and provide tools to remember when to take those medications; 
• Patient advocacy groups can provide tools to prepare for a doctor's visit; and
• Local advertising and marketing agencies can volunteer their services to test print materials for readability and comprehension.

The general objectives of this activity are to conduct a youth mapping activity that:

• Increase the awareness of problems related to low health literacy in a defined community;
• Create a replicable model to use in other communities;
• Create and strengthen positive youth development; and
• Disseminate findings and insights to key audiences to generate future activities and opportunities

CYM has been successfully used across the United States to engage youth and adults in community development and change. The process begins with youth trained to collect data that help to provide a comprehensive look at existing community resources. The resulting CYM database highlights resource availability, explores gaps in community resources, and serves as a basis for organizing community change.