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Improving health literacy on the Island: Language barriers and lack of reading skills hamper can patients' healthcare decisions

Tuesday, December 15, 2009

STATEN ISLAND, N.Y. -- When Victor Luna came to the United States from Mexico in 2004, he was nervous about going to doctors because of a language barrier. But after taking health literacy classes, the Oakwood resident is no longer afraid.

During Staten Island's first Health Literacy & Cultural Competency Conference held last month at Staten Island University Hospital's Ocean Breeze campus, Luna told about 60 people how the classes helped him. Having learned about different aspects of healthcare, Luna recounted how he called his mother in Mexico after a lesson on breast cancer and told her how to do a self-exam.

"I believe it is important to have health classes because many times we are not informed about the diseases that are all around us," Luna said. "Some of them are unknown or alien to us, sometimes we don't have the knowledge or ability to prevent them."

According to the American Medical Association (AMA), health literacy is the ability to obtain, process and understand basic health information and services needed to make appropriate health decisions and follow instructions for treatment. A recent government study estimates that more than 89 million American adults have limited health literacy skills -- including people of all ages, races, income and education levels.

The SIUH conference brought together community members, healthcare providers and adult educators to discuss health literacy on Staten Island. Topics included developing reader-friendly patient education material and health literacy electronic information resources.

"Low health literacy is not just affecting people who don't speak English, a majority are native-born Americans who speak English," noted Celina Ramsey, limited English proficiency and health literacy coordinator at SIUH. "They are so unaware of the detrimental affects; they don't understand health care information or the future of their health."

Ms. Ramsey, who led the program, spoke to the group about improving patient/provider communication with simple language. During the session, she showed an AMA video featuring those with low health literacy and discussed how healthcare providers can simplify medical jargon for patients.

She taught attendees the Teach Back method and paired them up to practice it. With the technique, people receiving health information are asked to restate it to their providers in their own words, not just repeat it, to ensure that it's understood and remembered.

"Most health documents are written at a 12th-, 13th-, 14th-grade level," Ms. Ramsey explained. "Most Americans read at or below an eighth-grade level. We are trying to promote patient education and material written at a fifth-grade level."

SIUH has offered health literacy classes for more than two years. The conference was part of a grant from the National Library of Medicine the hospital received in April to bring its health literacy curriculum into adult education programs across the Island. SIUH has since partnered with the Jewish Community Center, New York Public Library, Community Health Center of Richmond, El Centro del Inmigrante and the YMCA to teach health literacy through ESL classes.

The next step is a boroughwide Health Literacy Collaboration that will have its inaugural meeting Jan. 15 at the hospital's Medical Arts Pavilion. Open to the community, the collaboration aims to bring different groups together to promote health literacy and educate others.

"I want to be able to share everything that everyone's doing," Ms. Ramsey said. "If we all come together, we can make a health literacy standard on Staten Island."

For more information about the Health Literacy Collaboration, call Ms. Ramsey at 718-226-8435.

Andrea Boyarsky is a features reporter for the Advance. She may be reached at

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