HEALTH LITERACY INTERVENTIONS IN SOUTHEASTERN SAN DIEGO
Investigators: Tamara Powell, Dr. Michael Cole, and Jaime Peterson


In 2000, congressional legislation called for the formation of the NIH National Center on Minority Health and Health Disparities and a strategic plan for addressing the poor state of health of racial and ethnic minorities, those with low income, and other disadvantaged groups in the United States (Thompson, Mitchell, & Williams, 1). Since this call to action, a rapidly growing field of medical and public health inquiry has emerged, investigating why the health of minority populations is worse than the health of the overall population and how this condition can be "reduced and ultimately eliminated" (ibid). Health Disparities Research, as this emerging field is called, attempts to determine the "causes and effects" of racial, ethnic, and socio-economic disparities in health and health care in the United States so that appropriate and effective interventions can be initiated. One type of intervention that several health disparities researchers promote is increasing health literacy amongst the underserved. "Health literacy," as defined by Healthy People 2010 (2000), a publication of the U.S. Department of Health and Human Services, is: "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (8). Health literacy is said to empower patients by "improving people's access to health information and their capacity to use it effectively" and is considered to be an "outcome" of "health education and communication activities" (Nutbeam, 2000, ΒΆ 1). Many medical professionals and public health officials are convinced that improving health literacy is an essential strategy for closing the "health gap" and are advocating for an increase in health education programs in low-income areas, especially with youth.

With the building enthusiasm around health education programs to promote health literacy in minority and underserved youth, we have become intrigued by a set of questions that are not sufficiently addressed in the medical and public health literature:

  • Does health-literacy education necessarily lead children into a life of healthy(ier) practices? A belief that this is indeed the case seems to be based on particular assumptions of the power of concepts to govern behavior, as well as a model of communication that is unidirectional. Both of these assumptions have been complicated by communication research and it could prove fruitful to address these assumptions from a critical perspective.
  • How do institutions of medical practitioners coordinate with other institutions -- such as community groups, schools, and other scholarly communities -- in order to work toward improving health literacy in targeted neighborhoods?
  • What do health-literacy interventions look like "on the ground" as institutions attempt to impact the everyday lives and practices of historically- and culturally-constituted "disadvantaged" groups.

We suspect that there may be something that a cultural-historical perspective on literacy, culture, activity, and development can add to this conversation. To begin, we propose to conduct an ethnographic study of the UC-wide Program in Medical Education (PRIME) that aims to equip future physicians to address growing health disparities in the state of California. We will observe PRIME instructors' and students' as they: engage in inter-institutional coordination practices; develop methods for connecting with target "patient populations"; participate in the everyday, objective-oriented practices of this growing group of medical professionals who share an interest in increasing health literacy among minority and underserved groups.

We will also work collaboratively with the UC San Diego PRIME students to design, implement, and assess the health literacy interventions they engage in -- particularly the high school health education outreach program titled "Healthy Minds, Healthy Bodies."

Works Cited

Nutbeam, D. (2000). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. In Health Promotion International, 15(3), pp. 259-267.

Thomson, G. E.; Mitchell, F.; & Williams, M. (2006). Examining the health disparities research plan of the National Institutes of Health: Unfinished business. New York: National Academies Press.

U.S. Department of Health and Human Services. (2000). Healthy People 2010: Understanding and Improving Health (2nd ed). Washington, DC: U.S. Government Printing Office.