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Health Education Leadership, KY
Vail, A., F.D. Scutchfield, D. Murray
Department of Human Environmental Sciences
Health literacy is the foundation for the development of Extension health education programs. A deeper understanding, evaluation, and development of health literacy concepts are the focus of this project. Health Education Leadership, KY addresses the need for further evaluation of both the concept of health literacy and its role in health outcomes as documented by the Agency for Healthcare Research and Quality.
The current literature focuses patient-centered approaches in the health care system. This project's approach is a family-centered approach in a community system addressing the challenge of improving health literacy through enrolling individuals in a health literacy program. The project will evaluate the efficacy of conducting a face-to-face health literacy intervention to improve the functional health literacy in low socio-economic status rural communities, in low SES urban communities, as compared to high SES communities.
One of the health literacy issues surrounds the impact of vitamin D on chronic diseases and overall well-being of Kentuckians. Research has now well established that Americans are deficient in vitamin D and that the daily intake recommended by several respected nutrition-information sources is inadequate. In analyses of 1988-1994 National Health and Nutrition Examination of 1988-1994 data, researchers determined that the prevalence of mild-to-moderate vitamin D insufficiency ranged from 34.4% among white men to 77.5% for black women. Severe deficiency ran as high as 3.4% in elderly women and 11.2% among black women. A similar analysis found that the prevalence of insufficiency among children age 1-11 was 69%.
A multitude of observational studies and several research studies provide strong evidence that certain levels of vitamin D provide protection against cancer. The evidence is strongest for colon cancer. In the most well-controlled trial to date, researchers estimated that there is a 35% risk reduction for every 25nmol/L 10ng/mL increase in vitamin D level.
In addition to cancer prevention, there is also ample evidence that low vitamin D levels are associated with glycemic control in diabetics, incidence and sequelae of cardiovascular disease, frequency of falls and cognitive impairment in the elderly, development of upper respiratory infections and asthma, symptoms and progression of rheumatoid arthritis and multiple sclerosis, and symptoms of fibromyalgia. In addition, several studies show that achieving adequate vitamin D levels in pregnancy and infancy reduces risk of the child later developing Type I diabetes.
Because blacks in the developed world suffer disproportionately from many of the aforementioned cancers and conditions, and those with darker skin are consistently found to have reduced vitamin D levels, there is much speculation on whether equalizing vitamin D through supplementation could also reduce racial disparities in health status. Increasing public and health provider knowledge and awareness of the benefits of achieving adequate vitamin D levels has the potential to reduce health disparities and the burden of chronic disease.