Background Information About Health And Literacy
The materials included in this section cover adult education techniques, describe the links between health status and literacy status, and uncover myths and cultural stereotypes about "illiteracy" and health care. Books are included to familiarize people with the philosophy of "participatory" or "popular" education, a technique that works well for helping people not only learn health facts but to actually incorporate healthy changes into their lives. Reports included look at adult literacy programs that integrate an "empowerment" approach to health in their classrooms. Other titles cover the important research linking limited literacy to lower health status. A few titles provide concrete how-to information for those wishing to bring health into their adult literacy classrooms or for those working with limited-literacy populations. There are also background works that look at the issue of culture: how culture shapes our view of health and our health care needs, and how culture shapes our relationship to literacy.
These background materials are either books or reports. For journal literature, see the section titled Bibliographies and Databases. Many of the materials listed there will provide citations to journal literature about health and literacy.
Auerbach, Elsa. Making Meaning, Making Change: Participatory Curriculum Development for Adult ESL Literacy. McHenry, IL: Delta Systems, 1992.
Available from: Delta Systems; phone (800) 323-8270; $16.95.
This 132-page curriculum guidebook invites readers to share their experiences and assumptions about literacy, and to work together to investigate new ways of teaching. Elsa Auerbach documents the University of Massachusetts Family Literacy Project. In this project, adult ESOL literacy teachers and students collaborated on a literacy curriculum relevant to students' life experiences. Included are strategies for learning about student concerns, and tips on developing curriculum based on student themes. Examples range from conducting oral histories and student-led research to using photos in the classroom. Included are chapters on how to use the literacy classroom as a site for students to gain confidence and skills to make positive changes in their lives, and how to evaluate the success of a curriculum. A bibliography is also included.
Keywords: Literacy education, learner-centered / Oral history
Brandes, Wendy L., et al. Literacy, Health, and the Law: An Exploration of the Law and the Plight of Marginal Readers Within the Health Care System: Advocating for Patients and Providers. Philadelphia: Health Promotion Council of Southeastern Pennsylvania, Inc., 1996.
Available from: Health Literacy Project; Health Promotion Council; 311 S. Juniper Street, Suite 308; Philadelphia, PA 19107; phone (215) 546-1276; fax (215) 545-1395; $20.
This 75-page publication is directed to health professionals who bear responsibility for consumer education, and can be an enlightening piece for adult literacy educators who want to learn more about the concerns of the health care community. Part one covers legal considerations, such as the case law about informed consent and risk communication when communicating with health care consumers who have limited literacy skills. Part two makes recommendations for system-wide changes and for changes that individual providers can make in order to improve communication with health care consumers who have limited literacy skills. Copies of the Rapid Estimate of Adult Literacy in Medicine (REALM), SMOG Readability formula, and the FRY Readability Graph are included, as are key background literature references.
Keywords: Health education / Law / Reading -- Ability testing
Breen, Mary J. Partners in Practice: The Literacy and Health Project Phase Two August 1990-October 1992: Summary Report. Toronto: Ontario Public Health Association, 1993.
Available from: Ontario Public Health Association; 468 Queen Street, E., #202; Toronto, Ontario M5A 1T7 CANADA; phone (416) 367-3313; $10.
This 30-page Canadian report provides valuable information for people interested in forging collaborations between health and literacy initiatives. The report: 1) summarizes the link between health status and literacy status; 2) describes Phase Two of the Literacy and Health Project; and 3) discusses some of the advantages and problems of using "clear language." Some of the reasons given for the correlation between limited literacy and low health status include restricted access to health information and restricted access to safe, meaningful, well-paid employment. The goals of Phase Two of the Literacy and Health Project included: 1) writing a position paper on literacy and health; 2) fostering community and individual health and literacy partnerships; and 3) establishing a clearinghouse for literacy and health information. The position paper describes the extent of people's reading problems in Canada, the detrimental effect these have on people's health, and what a commitment to equal access to health and information would mean for Canadians. The section on community collaborations includes a description of what health, literacy, and community people learned from each other, and describes materials development using community members, not just literacy or health experts, as field testers. The report ends with some recommendations for continued work to address literacy and health problems. It includes a bibliography.
Keywords: Health status / Literacy -- Research / Literacy -- Social aspects
Canadian Congress for Learning Opportunities for Women. Isolating the Barriers and Strategies for Prevention. Toronto: Canadian Congress for Learning Opportunities for Women, 1995.
Available from: Canadian Congress for Learning Opportunities for Women; 47 Main Street; Toronto, Ontario M4E 2V6 CANADA; phone (416) 699-1909; fax (416) 699-2145; $11.
This 85-page document, intended for adult educators, looks at the ways violence in women's lives affects their ability to learn, and strategies for making women's classroom experiences safer in order to help women learn. Also included are reports from workshops held in four parts of Canada and women's personal narratives about how violence has affected their lives. A bibliography is included.
Keywords: Domestic violence / Lesbians / Literacy -- Social aspects
Doak, Cecilia C., Leonard G. Doak, and Jane H. Root. Teaching Patients With Low Literacy Skills. 2d ed. Philadelphia: Lippincott Co., 1996.
Available from: J. B. Lippincott Co.; phone (800) 777-2295; $27.95.
Written for health care providers and educators, this 212-page book describes the extent and nature of people's struggle with reading in the United States and how to convey health information despite the barrier of limited literacy. A classic in the field, this book is also of value to literacy educators. The book covers educational theories about how adults learn; tips for teaching; how to test the literacy skills of patients; how to assess the suitability of health education materials; how to write and create visuals for easy-to-understand information; how to test and revise materials once they are created; and how to teach using technology. A copy of the REALM test is included. Included here is the Doak's Suitability Assessment of Materials (SAM) instrument. SAM provides a detailed way to assess the content, literacy demand, graphics, layout and typography, learning stimulation, and cultural appropriateness of materials. SAM has been tested with 172 health care providers from several cultures.
Keywords: Health education / Materials assessment / Materials development / Reading -- Ability testing
Freire, Paolo. Education for Critical Consciousness. New York: Continuum Publishing Company, 1973.
Available from: Continuum Publishing Company; phone (800) 561-7704; $15.95.
This 164-page book includes two essays by Paolo Freire, the man who introduced the problem-posing technique of popular education to the United States. The essays are Education as the Practice of Freedom and Extension or Communication. The first essay is about Friere's work in Brazil with "illiterates," that explains his process of using "culture circles" and "generative words" instead of the traditional teacher-led learning processes to teach adult literacy. Crucial to his work is the idea of teaching people to have a "critical attitude" toward the world, so that they can make sense of their world and find ways to change it or take action. Included in the appendix are the drawings he used in his "culture circles" and the 17 "generative words" for his work with peasants in Brazil. While the prose can be dense, it presents the origins of the popular education or participatory education techniques which have worked so well in the United States with teaching health in literacy settings.
Keywords: Literacy education, learner-centered
Hohn, Marcia Drew. Empowerment Health Education in Adult Literacy: A Guide for Public Health and Adult Literacy Practitioners, Policy Makers and Funders. [Print and online versions] Literacy Leader Fellowship Program Reports: Vol. III, No. 4, Part A. Washington, DC: NIFL, 1998.
Available at: http://www.nifl.gov/hohn/HOHN.HTM, free.
Also available in print from: National Institute for Literacy; 800 Connecticut Avenue, NW; Washington, DC 20202-7560; phone (800) 228-8813; free.
This 151-page, large print report was written for public health and adult literacy practitioners, policymakers and funders. It begins with a discussion of the connections between literacy level and health status. It includes a description of the research process engaged in by the author, who examined a health promotion project taking place in an adult education program. The project used a participatory approach: a team of adult literacy students set the agenda for what topics to research and how to teach the material to others. The research itself was designed as action research with the students having a say in setting the research parameters. The author describes two education campaigns of the team: one on early detection of breast, cervical, and testicular cancer, and one on family violence. She includes some proposed implications for policy and funding. The report concludes with suggestions for adult literacy practitioners and health practitioners interested in using an "empowerment" methodology to teach health issues with limited literacy audiences. It includes an extensive bibliography.
Keywords: Action research / Health education / Literacy education, learner-centered
Horsman, Jennifer. Something in My Mind Besides the Everyday. Toronto: The Women's Press, 1990.
Available from: InBook Distributors; phone (800) 626-4330; $13.95.
The author of this 238-page study set out to challenge the myths of illiteracy by listening to women's accounts of their own lives. In the process she has written an enlightening book for literacy and health workers alike. She interviewed 23 women participating in literacy and training programs and 10 workers in these programs in 1986 in rural Nova Scotia. She examines some of the myths about illiteracy such as literacy will automatically improve lives; "illiterates" can't think abstractly or use logic; and women are to blame for their own illiteracy. She identifies social structures that support the myths of illiteracy, including the ways in which the media creates an artificial division between "illiterates" and "literates"; lumps all people who can't read into a homogeneous group; and imposes "standard" English as superior to other forms of speech or writing. Horsman notes that while there is talk in the media about how many people can't read, social structures are still set up as if everyone can. She also looks at how women labeled as "illiterate" both resist the dominant discourse by refusing to be labeled as "stupid," and how they define their literacy needs in contrast to what the literacy programs think they need. The author makes a powerful case for valuing these womens' experiences and recognizing that many left school for complex reasons rather than lack of motivation.
Keywords: Literacy -- Research / Literacy -- Social aspects / Rural populations / White ethnic communities
LaMachia, Joan and Elizabeth Morrish. Ideas in Action: Participatory Health and Literacy Education With Adults: Discussion Guide for Adult Basic Education and Literacy Instructors, Health Educators and Others. [Discussion guide and video] Cambridge, MA: MCET, 1996.
Available from: Jack Casey; Massachusetts Corporation for Educational Telecommunications; One Kendall Square, Building 1500; Cambridge, MA 02139-1562; phone (617) 252-5700; fax (617) 252-5709; http://www.mcet.edu; $99.95.
This approximately 80-page guidebook for literacy and health educators describes several methods of participatory education, and gives examples of how a participatory methodology can be used to teach health. It addresses some of the concerns teachers may have about using health content or participatory teaching techniques. Included are samples of student-created products, and writings by teachers describing their personal feelings about this type of health and literacy education. A short annotated bibliography is included. A listing of organizational resources in Massachusetts is included, but is becoming outdated. Examples of successful participatory health and literacy projects in Massachusetts adult education programs are featured in the video.
Keywords: Health education / Literacy education, learner-centered
Norton, Mary and Pat Campbell. Learning for Our Health: A Resource Book for Participatory Literacy and Health Education. Edmonton, AB: The Learning Centre Literacy Association, 1998.
Available from: The Learning Centre; 10116 105 Ave.; Edmonton, Alberta T5H 0K2 CANADA; phone (403) 429-0675; fax (403) 425-2205; <email@example.com>; cost not yet determined.
This forthcoming book is a resource for people in literacy programs, public health centers, and community agencies interested in conducting workshops on health issues using a participatory teaching style. It was developed with women in an adult literacy program, and includes workshop outlines on topics such as stress, saying no, anger, eating patterns, menopause, and living with welfare incomes. The introduction discusses the relationships between health and literacy, describes the participatory process and perspectives used in the workshops, and includes comments about applying the process in practice.
Keywords: Health education / Literacy education, learner-centered
Perrin, Burt. Literacy and Health: Making the Connection: The Research Report of the Literacy and Health Project, Phase One: Making the World Healthier and Safer for People Who Can't Read. Toronto: Ontario Public Health Association, 1990.
Available from: Ontario Public Health Association; 468 Queen Street East, Suite 202; Toronto, Ontario M5A 1T7 CANADA; phone (416) 367-3313; $10.
This 60-page report explores the relationship between literacy and health; looks at what is being done to enable people with limited literacy skills to live healthier and safer lives; and makes some proposals for the future. The authors reviewed health data; reviewed literature across areas including medicine, education, and poverty research; sent a brief questionnaire to health and literacy organizations; and conducted case studies. The report describes the direct and indirect impact of illiteracy on health, ranging from incorrect use of medications to stress and low self-esteem. It details Canada's level of awareness of the problems resulting from illiteracy--over 20 percent of their survey respondents reported not being aware of a connection. Finally, it discusses potential solutions such as: 1) a commitment to the reduction of health inequities and a reduction of illiteracy by teaching people to read; 2) heightened awareness within the health community; 3) working together with communities in need of health and literacy services; 4) provision of health information other than via the written word; and 5) simplifying written information about health. It includes a bibliography and lists priorities for future research.
Keywords: Health status / Literacy -- Research / Literacy -- Social aspects
Purcell-Gates, Victoria. Other People's Words: The Cycle of Low Literacy. Cambridge, MA: Harvard University Press, 1995.
Available from: Harvard University Press; phone (800) 448-2242; $17.50.
This 242-page case study of an urban white Appalachian family traces two years in the mother and son's struggle to learn to read. The author writes an engaging story in which she describes some of the cultural barriers for literacy acquisition and details the steps she feels are necessary to make learning to read and write make sense to people who live in an oral-based culture.
Keywords: Literacy -- Research / Literacy -- Social aspects / Urban populations / White ethnic communities
Sauerhaft, Beth and Marty Williams. Who Holds the Mirror?: The Mural, Oral Histories, and Pedagogy of the Breast Cancer Oral History Action Project. [S.l.]: Wendy Earl Productions, 1998.
Available from: Peppercorn Books and Press; P.O. Box 693; Snow Camp, NC 27349; phone (336) 574-1634; fax (336) 376-9099; $10.
This 100-page report is a companion piece to a traveling mural, Who Holds the Mirror? but is valuable on its own as well. The report has information of interest for a diverse audience of literacy educators, policymakers in the fields of health and literacy, adult education students, and community activists. It describes the process of bringing literacy students together to conduct action research into the breast cancer epidemic. It includes a description of the people included in the mural and the ideas embodied in the mural. Over half of the pages of this publication are devoted to the oral histories of women who have had breast cancer. The oral histories were gathered by women conducting action research as part of a literacy class. They chose to interview low-income women and women of color, who are generally ignored in mainstream accounts of breast cancer. Some of the oral histories are in English, some in Spanish, and others in Chinese. The report includes a selected listing of health, environmental, literacy and community organizations to help people who want to do similar work.
Keywords: Action research / Breast cancer / Literacy education, learner-centered / Oral history / People of color
Schultz, Marilou and Miriam Kroeger. Teaching and Learning With Native Americans: A Handbook for Non-Native American Adult Educators. Phoenix: Arizona Adult Literacy and Technology Resource Center, 1996. [Online] 17 November 1998.
Available at: http://literacynet.org/linksadedlit.html, scroll to "Curriculum and Resource Materials"; free.
This approximately 23-page Web site was compiled from the Four Winds Walk in Balance on Mother Earth Curriculum Guide for the Arizona Adult Literacy and Technology Resource Center, Inc. It includes guidelines for working with Native Americans in adult education settings, including issues such as how to find "teachable moments," how to look at the interconnectedness of knowledge, and how to respect others' cultures. The focus is on Navajo Indians living in Arizona, but the principles described are generally applicable. It includes information about cultural aspects of substance abuse; aging; barriers to accessing health services; and emotional and psychological issues. The link to this site has changed several times over the past few months. If it is hard to find, try contacting the Arizona Adult Literacy and Technology Resource Center at (602) 265-0231.
Keywords: Aging / Intercultural communication / Mental health / Native Americans / Substance abuse
Spector, Rachel E. Cultural Diversity in Health and Illness. 4th ed. Stamford, CT: Appleton and Lange, 1996.
Available from: Appleton and Lange; phone (800) 423-1359; $36.95.
While directed primarily toward health professionals, this 407-page textbook includes a wealth of information that could help adult educators understand the health care beliefs of their students. Unit One helps health care providers become aware of their own beliefs about health and illness. Unit Two focuses on problems encountered by clients when using the health care system and ways in which medicine has become an instrument of social control. Included is a description of alternatives to the allopathic tradition, including "magico-religious" alternatives. Unit Three includes chapters on how different communities--including African Americans, Asian Americans, Latin Americans, Native Americans, and Whites--view and experience health and illness. Extensive bibliographies and organizational resources are included.
Keywords: African Americans / Alternative medicine /Asian Americans / Intercultural communication / Latin Americans / Medical care -- Political aspects / Native Americans / White ethnic communities
Szudy, Elizabeth and Michele González Arroyo. The Right to Understand: Linking Literacy to Health and Safety Training. Berkeley: Labor Occupational Health Program, University of California, 1994.
Available from: Labor Occupational Health Program; Attn: Publications; 2223 Fulton Street, 4th Floor; Berkeley, CA 94720-5120; phone (510) 642-5507; $20.
This 200-page manual uses clear language and illustrations to introduce health and safety trainers to the experiences and training needs of workers with limited literacy skills. The materials are adaptable for ESOL students. Literacy instructors will find ideas, such as using skits, drawing maps, or using visuals to spark discussion for introducing occupation safety into the classroom. It provides facts and personal stories to illustrate the need for training programs aimed at participants with a range of literacy skills. It provides trainers with tools and practical tips for developing materials and programs for people with limited literacy. The chapters cover facts about literacy, health and safety; workers' stories about struggling with reading; how to conduct a needs assessment of people's literacy skills and how to test people's knowledge of health and safety issues; how to develop easy-to-read materials; how to evaluate the readability of materials; how to conduct trainings that will work well for people with a range of literacy skills; and how to encourage and support others in doing literacy and health work. Additional resources are included. In developing this manual, the authors consulted with a large number of literacy experts, held focus groups with workers, and worked as literacy tutors to get a more in-depth understanding of the issues they describe.
Keywords: Materials development / Needs assessment / Occupational health and safety / Reading -- Ability testing / Training methods
Vella, Jane. Learning to Listen, Learning to Teach. San Francisco: Jossey-Bass, 1994.
Available from: Jossey-Bass; phone (800) 956-7339; $18.95.
The author of this 200-page book describes twelve principles of adult education using stories from her personal experience around the world teaching everybody from doctors to workers in refugee camps. Vella wrote this book for administrators and teachers, health educators, and physicians -- anybody who works with adult learners. Examples of some of the principles include allowing the learner to be a decision maker; promoting open communication; including learners in setting goals and assessing needs; honoring cultural perspectives; teamwork; learning through doing and feeling; and making the teacher accountable to the students.
Keywords: Intercultural communication / Literacy education, learner-centered