In my professional career, I was privileged to work with the vulnerable and underserved population. Many of the clients we served were struggling with low levels of literacy. Some clients were immigrants and English was not their first language. Almost everyone had difficulty accessing and understanding health information. Some were unprepared to make informed health decisions to manage their health conditions.
I think we all know people who are struggling with some form of illiteracy. According to research studies, approximately 90 million Americans struggle with illiteracy or low literacy. Some people may not understand certain information and are not aware they do not understand. In my last post, I wrote that my mentors told me years ago that no one can act beyond their knowledge. There are some people who do not know what they do not know. Their decisions, actions and beliefs may be founded on incorrect information.
Sometimes illiteracy is hidden. Many adults with functional illiteracy learned to hide their challenges. They may be faced with many barriers that prevent them from developing a level of proficiency. They may be embarrassed by their level of literacy and develop what is called faking skills. They develop strategies that hide their problem from family members and the public.
People who are illiterate are very intelligent people who acquired other skills but for various reasons have not acquired competence or proficiency in literacy. To understand what these individuals are experiencing and living with, we have to eliminate our prejudices, stereotypes, myths and misconceptions about illiteracy. Erroneous assumptions can lead to discriminatory practices. When we change our mindsets by our awareness, understanding and willingness to help, we become part of the solution.
Literacy is the foundation for successful learning. Without the ability to read, people lack the skills to be successful in their academic careers, work careers and their life options are limited. Unfortunately, many illiterate people live in poverty. Employees without a high school diploma earn less money than those with more education. This deeply affects their ability to break the cycle of poverty.
Literacy has traditionally meant the ability to read and write. In today’s society, this definition has been expanded to include the ability to use computers, social media, solve math problems and other basic means to understand, communicate and gain useful knowledge.
Illiteracy means the inability to read or write. Low literacy means the inability to read, write and use numbers effectively. The association between low literacy is associated with a range of adverse health outcomes. Health literacy requires a complex group of reading, listening and decision making skills and the ability to apply these skills to health situations. Functional literacy consists of reading and writing skills that are inadequate to manage daily living and employment tasks.
Sometimes, literacy skills were not developed during childhood because of undiagnosed learning difficulties. Learning disorders like dyslexia can interrupt a person’s ability to identify speech sounds and learning how to relate to letters and words. Dyslexia affects areas of the brain that process language.
There are some startling facts about literacy. According to the Literacy Project Foundation, 50percent of adults in this country cannot read a book written at the 8th grade level. It is estimated that three out of four people receiving government benefits or welfare can’t read. Approximately 50% of unemployed people between the ages of 16 and 21 cannot read well enough to be considered functionally literate.
Illiteracy, low literacy and functional literacy may prevent people to read contracts, get a loan, participate in social media, read books, read bills or other mail. Some people are not able to read letters written at a 6th grade level and have to depend on others to read the information to them. Recent statistics show that two thirds of students who are unable to read proficiently by the end of the 4th grade will drop out of school, end up in jail or on welfare. They will suffer a 78% chance of not catching up. Prison systems show recidivism rate higher in people who do not receive literacy assistance. Approximately one in four children grows up not knowing to read. Illiteracy may be passed along by parents who cannot read or write. They may not know how to help their children.
According to the US Department of Education, approximately 60 percent of prison inmates are illiterate and 85 percent of juvenile offenders have reading problems. Every state has a large percentage of students who are not able to read at grade level. Nationally, more than 8 million low income students in kindergarten through fifth grade are not proficient in reading. If these students do not receive effective intervention early, they are less likely to become grade level readers. With proper evidence-based interventions in the early grades, children can become average or better readers.
Our health care system place a lot of demands on patients and clients. Some of these demands include the complexity of choosing health care plans, navigating the health care system, use of electronic communication and other technology, completing extensive health questionnaires, short doctor office visits, ineffective communication leading to limited understanding of treatment plans and discharge instructions. Many people are not prepared for these demands. Some people don’t make medical appointments because they can’t complete the requested information. These demands may lead to health disparities in clients with low literacy levels.
Low health literacy is a strong predicator of health outcomes and intersects with social determinants of health. The social determinants of health are the economic and social conditions that influence individual and group differences in health status. Individuals with limited health literacy may not be knowledgeable about the body or causes of disease. Without this knowledge, they may not understand about the relationship between lifestyle factors and health outcomes. We don’t exist in a vacuum. Health care professionals must understand the needs of this population when making decisions.
Adults who are willing to go back to school to improve their reading, spelling and math skills are taking a big step, one that could lead to major improvements in their lives. These brave efforts should be encouraged and supported.
I’ve included some resources to help adult learners. Other resources may be available at your local library. You can prevail over illiteracy!
References
Literacy Project Foundation. Website. Accessed May 8, 2020
US Department of Education. Website. Accessed May 8, 2020.
Some Adult Literacy Program Resources
LINCS
Local Library
ProLiteracy