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The National Assessment of Adult Literacy: Health Literacy Results

December 5, 2007

Peggy CarrAssociate Commissioner National Center for Education Statistics

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Discussion Topics

• Measuring health literacy

• Comparing health literacy with other types of literacy

• Reporting the results

• Describing adults with Below Basic and Basic Health Literacy

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National Assessment of Adult Literacy (NAAL)

• Assessment of the English literacy of U.S. adults

– Prose, Document, Quantitative Scales

• Conducted in 1992 and 2003

• Nationally representative sample of more than 19,000 adults age 16 and older

• One-on-one administration in households and prisons

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Proficient Can perform complex and challenging literacy activities

Intermediate Can perform moderately challenging literacy activities

Basic Can perform simple everyday literacy activities

Below Basic Can perform no more than the most simple andconcrete literacy activities

Proficient Can perform complex and challenging literacy activities

Intermediate Can perform moderately challenging literacy activities

Basic Can perform simple everyday literacy activities

Below Basic Can perform no more than the most simple andconcrete literacy activities

Descriptions of Literacy Levels

Nonliterate in English—unable to complete a minimum number of screening tasks or could not be tested because did not speak English or Spanish

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Measuring Health Literacy

• The health literacy tasks encompassed three domains of information: clinical, prevention, and navigation of the health care system

• The health literacy scale did not measure the ability to obtain information from nonprint sources

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Health Literacy & Literacy Are Closely Related

Similarities:

– Both involve the ability to recognize and understand words, search text, and make text-based inferences

Differences:

– The health literacy scale required some information about health and the U.S. health system, including :

• common health-related vocabulary

• typical structure of written health materials

• workings of the health care system

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Vaccination Schedule

All Adults

Below

Basic

Basic Intermediate Proficient

Percent Correct

(millions)

58

(126)

5

(2)

22

(10)

78

(89)

100

(25)

Question: Refer to the chart to answer the following question. How many polio vaccinations should children have received by the time they are 7 years old?

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X-ray Instructions

All Adults Below Basic Basic Intermediate Proficient

Percent Correct

(millions)

85

(184)

36

(11)

79

(38)

97

(110)

100

(25)

Question: Refer to the X-ray instructions below to answer the following question. What can you drink the morning of your X-ray?

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Sample Task From the Alternative Assessment Question: What does the label say a person should doin case of an overdose?

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Overlap Between Below Basic and Nonliterate in English

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Percentage of Adults in Each Literacy Level: 2003

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1The “Did not obtain health information over the Internet” category does not include prison inmates because they do not have access to the Internet.2Disabilities include vision, hearing, learning disability, and other health problems.SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics, 2003 National Assessment of Adult Literacy (NAAL).

Percentage of Adults in the Below Basic Health Literacy NAAL Population: 2003

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Percentage of Adults in Each Health Literacy Level, by Educational Attainment : 2003

NOTE: Adults are defined as people 16 years of age and older living in households or prisons. Adults who could not be interviewed due to language spoken or cognitive or mental disabilities (3 percent in 2003) are excluded from this figure. SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics, 2003 National Assessment of Adult Literacy.

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Percentage of Adults in Each Health Literacy Level, by Languages Spoken Before Starting School: 2003

NOTE: Adults are defined as people 16 years of age and older living in households or prisons. Adults who could not be interviewed due to language spoken or cognitive or mental disabilities (3 percent in 2003) are excluded from this figure. SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics, 2003 National Assessment of Adult Literacy.

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Percentage of Adults in Each Health Literacy Level, by Self-Assessment of Overall Health: 2003

NOTE: Adults are defined as people 16 years of age and older living in households or prisons. Adults who could not be interviewed due to language spoken or cognitive or mental disabilities (3 percent in 2003) are excluded from this figure. SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics, 2003 National Assessment of Adult Literacy.

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Percentage of Adults that Never Obtain Health Information from the Internet: 2003

• Proficient 15%

• Intermediate 33%

• Basic 58%

• Below Basic 80%

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Percentage of Adults Obtaining Health Information from the Internet by Age: 2003

A lot Some A little None

100

80

60

40

20

0

16-18 19-24 25-39 40-49 50-64 65+

20

40

60

80

100

Percent got information

Percent got no information

23

27

25

25

710

77

21

22

34

23

18

26

34

23

16

28

37

19

14

24

47

16

5

Age

NOTE: Detail may not sum to totals because of rounding. SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics, 2003 National Assessment of Adult Literacy (NAAL).

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NAAL Reports

• A First Look at the Literacy of America’s Adults in the 21st Century

• Key Concepts and Features of the 2003 NAAL

• The Health Literacy of America’s Adults

• Literacy Behind Bars

• Literacy In Everyday Life

• Indirect County and State Estimates for 1992 and 2003

• Technical Report and Data File User’s Manual

• The Basic Reading Skills of America’s Adults

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NAAL Web-Site: http://nces.ed.gov/naal