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changes in marital status including loss of a spouse, and changes involving loss of
family members and friends. Additional challenges to healthy aging are a higher like-
lihood of developing chronic diseases and the limited availability of affordable trans-
portation resources, housing options, health care options, and personal care to help
people remain independent (Bernstein et al., 2003; Hogson & Cai, 2001).
One group within the older adult population that requires specific discussion is the

baby boomer population, which as it ages will markedly affect the proportions of
the elderly and the “ oldest old ” in the total population (Eggebeen & Sturgeon, 2006).
As a result of baby boomer aging, it is projected that one in five people will be 65 years

old or older by 2030 (Federal Interagency Forum on Aging - Related Statistics, 2006).
In fact, it has been suggested that the impact of the baby boom generation will be
equal to that of immigration during the first part of the twentieth century.

The majority of health educators seem ill - equipped for dealing with these demo-
graphic changes affecting the U.S. population. Furthermore, few if any health educators
complete any formal education in how to design, implement, and evaluate health promo-
tion programs targeting the older adult population. Moreover, some health educators might
not wish to work with the older adult population due to fears of facing their own aging
process (Hogson & Cai, 2001). This disconnect reveals the need for health educators to
become more educated in strategies designed to reach the older population. One strategy
to achieve this goal seeks to address the health literacy of the older adult population.

HEALTH LITERACY AMONG OLDER ADULTS

Health literacy may be defined as “ a multidimensional issue encompassing the ability

to read, understand, and use health information to make appropriate healthcare deci-
sions and follow instructions for treatment that allow patients to manage their health
and improve the quality of their lives ” (Brown et al., 2004, p. 150). It is a key issue to
be considered when dealing with elderly populations because it infl uences patient -
provider interactions, including compliance with treatment (Greene, Hibbard, &
Tusler, 2005; National Institute on Aging [NIA], 2006; Osborne, 2005).
Results from the 2003 National Assessment of Adult Literacy (NAAL) show that
29 percent of the adult population 65 years old and older had a health literacy profi -
ciency of 30 percent and were at the basic level, 38 percent were at the intermediate

level, and only 3 percent of the participants were at the proficient health literacy level
(Kutner, Greenberg, Jin, & Paulsen, 2006; NIA, 2006). According to these fi ndings,
adults 65 and older have the lowest health literacy level when compared to the average
level of the other age groups (Kutner et al., 2006; NIA, 2006).
According to a study by Lee, Gazmararian, and Arozullah (2006), older adult pop-
ulations with low health literacy tend to be comparatively isolated from the society in
which they live; therefore they obtain less social support and their health tends to
diminish as a consequence. Similarly, findings from the NAAL indicate that adults

categorized as being in the “ below basic ” range of health literacy have diffi culties
reading documents, filling in medical forms, and navigating the health care system

(Osborne, 2005; Powell, Hill, & Clancy, 2007).

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