More than ABCs: Health Literacy and Older Adults

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Stories of seniors struggling to take their medications correctly, failing to recognize chest pain as a sign of a possible heart attack or grappling with the multitude of new prescription drug plan options illustrate a glaring national problem — low health literacy levels among our nation’s fastest growing population.

A Kent State nursing professional and student assist an elderly patient during a checkup at Townhall II Clinic in Kent, Ohio. Photo by Gary Harwood

In the United States millions of people simply do not seek or use health information services. The poor, the educationally disadvantaged and older adults are among those who often are not health literate, according to a 2004 Institute for Healthcare Advancement study.

An interdisciplinary research team from Kent State University is investigating this important question of health literacy. With a National Leadership Grant of more than $500,000 from the Institute of Museum and Library Services, co-investigators Dr. Mary Stansbury, associate professor of library and information science, and Dr. Ruth Ludwick, professor of nursing, are examining the means by which older adults seek information on health issues, including understanding health care options and identifying symptoms of illness.

“The strongest predictor of an individual’s health status is not age, income, employment status, education or racial or ethnic group — it is health literacy,” says Ludwick.

Health literacy is generally referred to as the ability to access, understand and use health-related information to make decisions — a daunting task for most individuals.

The interdisciplinary research team includes Kent State faculty with expertise in nursing, library and information science and adult literacy. Researchers will evaluate all aspects of the health information-seeking process and make recommendations to help health-related institutions craft more effective health information programs and services.

This grant represents an effort that has developed from a new group at Kent State called the Center for Health Literacy. The group aims to improve the health literacy of adults and families and bring faculty and staff together from the colleges of Nursing, Communication and Information and Education, Health, and Human Services, along with the Northeastern Ohio Universities College of Medicine.

The team will administer surveys to arrive at a better understanding of how older adults from urban, rural and suburban settings get health information. Once the data is analyzed, focus groups will be conducted to clarify the roles of library and community health professionals in the provision of health information.

For many patients, accessing, understanding and using health-related information to make decisions is a daunting task, especially when it comes to medication and treatment choices.

“Ultimately, we will make generalized recommendations to guide program development and policy directed at improving health information-seeking skills among older adults,” Ludwick says. “Improving these skills is a vital step in decreasing health disparities in this population.”

While digital health information resources are widely available, Stansbury says, there is a substantial “digital divide” among seniors based on income, education, age and gender. In fact, studies have indicated many older adults do not seek or use health information from traditional health settings or the Internet.

“But they may utilize the services of other organizations in the community, such as churches, libraries, community centers and educational programs where there are opportunities for participating in ‘health information events,’ ” Stansbury says.

Better understanding of the means to present and deliver health information could pay dividends in the long run, and not just for seniors. The National Academy on an Aging Society estimates that low literacy skills are responsible for increasing annual health expenditures by $73 billion.

Individuals with low health literacy have higher medical costs due to a variety of factors, including more medication and treatment errors, increased hospitalizations, longer hospital stays, more doctor visits and lack of necessary skills to obtain needed services.

Ludwick says as a nation, we simply cannot afford to ignore the health information needs of our aging population, and this research initiative is a positive step toward addressing a fundamental problem that has serious personal, social and economic health costs.