Poor Health Literacy of Concern Says Turia

Questions and Answers

Kōrero Mārama, Health Literacy and Māori
Results from the 2006 Adult Literacy and Life Skills Survey

10 February 2010


What is health literacy?

Broadly speaking, health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information, in order to make appropriate health decisions.

Health literacy includes the skills people need to find their way to the right place in hospital, fill out medical and insurance forms, understand the instructions on a medicine bottle, and communicate with their health providers.

Health literacy is not just an issue for patients or users of health services. It is the responsibility of a range of people including health professionals and health promotion media.


What is Kōrero Mārama about?

Kōrero Mārama uses the data from the 2006 Adult Literacy and Life Skills (ALL) survey to describe the health literacy skills of Māori compared to non-Māori in New Zealand across a number of variables. The report presents findings by gender, rural and urban location, age, level of education, labour force status, and household income.


What are the key results from Kōrero Mārama?

Kōrero Mārama shows us that:

• On average, New Zealanders have poor health literacy skills, with both Māori and non-Māori males and females scoring on average less than 275, which is the minimum required score for individuals to meet the complex demands of everyday life and work in the emerging knowledge-based economy (as defined in the 2006 ALL survey).

• Four out of five Māori males and three out of four Māori females have poor health literacy skills.

• Māori who live in a rural location have on average the poorest health literacy skills, closely followed by Māori who live in an urban location.

• Māori in the 50–65, 16–18, and 19–24 years age groups have the poorest health literacy compared to the rest of the population. This is particularly concerning because over half of the Māori population (53%) was less than 25 years of age at the 2006 census. Also, older age groups have high levels of health need and are generally high users of health services.

• Māori and non-Māori with a tertiary education are more likely to have good health literacy skills compared to those with lower levels of education. This is consistent with international evidence.

• Māori across all labour force status types have poorer health literacy skills compared to non-Māori, but Māori who are unemployed or looking for work have the poorest health literacy skills of all groups.

• Māori across all income quintiles have poorer health literacy skills compared to non-Māori.

How do these findings compare internationally?

Health literacy has been identified as an issue in many countries, and in particular in those countries that took part in the ALL survey. New Zealand has a similar proportion of adults with low health literacy skills as Canada and Australia.

What is the response of the sector to these findings?

The Government is committed to improving the literacy and numeracy levels of all New Zealanders. The Government’s Education Policy outlines its Crusade for Literacy and Numeracy, which includes National Education Standards.

The Ministry of Health is focussed on addressing health literacy, and in accordance with its Statement of Intent has developed a work programme to improve health literacy for Māori whānau.

There is some positive work being carried out to improve health literacy by government agencies, health care providers, and at the community level. However, as health literacy is influenced by a number of factors, a more collaborative and concerted effort needs to be made across sectors.


What is the Adult Literacy and Life Skills survey?

The ALL is an international survey which tested the literacy, numeracy, and problem-solving skills of people aged 16–65. The ALL survey was conducted across a number of countries including New Zealand, Canada, Australia, the USA, and the Netherlands. In New Zealand, the ALL survey used a nationally representative sample of more than 7000 people.


What did the survey measure?

The ALL survey measured four domains:

• Prose literacy
• Document literacy
• Numeracy
• Problem-solving skills

The ALL survey contained 191 health-related items across the four domains from which health literacy could be measured. Each of the health-related questions in the ALL survey could be correlated to one of the following activities:

• health promotion
• health protection
• disease prevention
• health care maintenance
• system navigation

Health literacy was measured on a scale of 0 to 500, broken down into five skill levels. People who scored a score from 0 to 275 (levels one and two) were considered to have poor health literacy skills. People who scored between 276 and 500 (level three and above) were considered to have adequate to strong health literacy skills, meaning they were able to meet the complex demands of everyday life and work in the emerging knowledge-based economy.


What is the impact of poor health literacy skills?

Poor health literacy is linked to poor health outcomes and may also be a contributor to health inequalities. People with poor health literacy:

• are less likely to use prevention services
• have less knowledge of their illness, treatment, and medicines
• are less likely to manage their long-term/chronic condition
• are more likely to be hospitalised due to a chronic condition
• are more likely to use emergency services
• are more vulnerable to workplace injury, because they do not understand safety precaution messages.

ENDS.