Roles and Responsibilities of Libraries in Increasing Consumer Health Literacy and Reducing Health Disparities: Volume 47

This chapter introduces the focus of this volume – the many ways in which libraries and librarians are helping to increase people’s health literacy and reduce health disparities in their communities. The rampant and rapidly increasing health injustices that occur every day throughout the world are, in large part, caused and exacerbated by health information injustice – something which libraries and librarians are playing an instrumental role in addressing by ensuring the physical and intellectual accessibility of information for all. This chapter opens with an introduction to the central concepts of health justice and health information injustice, focusing on the many information-related factors that shape the degree to which individuals have the information they need to be able to have a sufficient and truly equitable chance to live a long and healthy life. Next, the authors present a timely case study to emphasize the importance of health information justice, looking at the dire importance of health literacy as we navigate the COVID-19 pandemic. The authors then provide a brief glimpse into their 13 contributed chapters, grouped into five categories: (1) Public Libraries/Healthy Communities; (2) Health Information Assessment; (3) Overcoming Barriers to Health Information Access; (4) Serving Disadvantaged Populations; and (5) Health Information as a Communal Asset. In conclusion, the authors discuss their aims for this volume, particularly that readers will become more aware of librarians’ efforts to address health disparities in their communities and excited about participating in and expanding these efforts, moving us closer to health justice.

Consumer health literacy is a necessary skill in all facets of library work, from reference desk to programming to website development. In this chapter, the authors present key terms in the domain of health literacy; challenges and controversies in research and public library practice; and findings from a recent study of public library workers meeting consumer health information needs. Finally, the authors present examples of National Library of Medicine (NLM) initiatives for public libraries and public librarians focusing on bridging health literacy gaps. Socially disadvantaged groups who are the most affected by health disparities tend to be those who are lower-income, have less education, and are not White. The combined effects of environment and socioeconomic status mean that these communities have particular, highly local challenges in addressing their health issues, as individuals and as a population. Health literacy can serve as the enabling factor in obtaining quality health information, navigating healthcare, and seeking better health. To support the public, NLM and its National Network of Libraries of Medicine have placed a strategic emphasis on public libraries in order to develop long-term partnerships. The goals of these partnerships are to support staff development and programming, and to promote resource-sharing about programs and activities focusing on health information. Public libraries are everywhere and open to all. This makes them the ideal community agency to reach out to the public and implement national information initiatives.

What does the intersection of food gardening and public librarianship look like? This chapter examines the question through a close analysis of three case studies that represent the spread of this phenomenon in the United States and Canada. This is a first step toward identifying areas for further research that will contribute to a more comprehensive understanding of how food gardening in and around public libraries addresses community-level health disparities. Although it is the case that food gardens and related programming are no strangers to public libraries, this topic has not received sustained attention in the LIS research literature. Public libraries have long been framed as key institutions in increasing consumer health literacy, but a more recent trend has seen them also framed as key institutions in promoting public and community health, particularly through the use of the public library space. This chapter examines food gardens at public libraries with this more expansive understanding of how public libraries address health disparities, by considering how this work occurs through novel partnerships and programs focused on transforming physical space in local communities. At the same time, public interest in food gardens parallels increased awareness of food in society; food and diet as key aspects of health; food justice activism; and a long history of community empowerment in the face of the proliferation of food deserts through myriad activities, including community food gardens. The authors consider how food gardening in public libraries parallels these trends.

The acceleration of Opioid deaths over the last decade has made it a serious national public health crisis. Alabama has not been immune to this epidemic, with dramatically increased age-adjusted drug overdose death rates. These increases have occurred in a state with limited resources for Opioid health prevention, treatment, and recovery services. This chapter introduces the term “o-CHIL” in order to better understand the multi-factorial layers of intertwining health injustices (in the plural) experienced in Alabama’s communities and their embedded public libraries. It highlights the complexities in Opioid consumer health information literacies, the culturally situated dimensions of the Opioid crisis in Alabama, and the uniquely relevant consumer health literacies in its public libraries. Findings are based on an empirical assessment of representative information support services identified in February 2020 on the websites of the 230 public libraries listed as members of the Alabama Public Library Service. The exploratory study applies website content analysis to identify seven examples of information offerings and to class offerings into three categories: (1) information sources (collections, resources); (2) information policy and planning (assigned Opioid-related role, strategic representation); and (3) connections (internal, external, news and events). The discussion potentially provides new directions, approaches, and opportunities to build collaborations of sharing within Alabama’s network of public libraries and beyond for them to better serve their local and regional communities impacted by the Opioid crisis.

This study investigates the intersections of health and social justice topics in the library and information science (LIS) curriculum. Course offerings from 60 American Library Association-Accredited LIS programs were extracted and comprised the study sample. Using a thematic content analysis, a total of 220 course descriptions were analyzed to assess the inclusion of health justice topics. A main finding was that only eight LIS course descriptions closely integrated health and social justice issues. In addition, four overarching thematic areas of LIS courses were identified from the dataset as conceptual pathways with the potential to further incorporate health justice aspects in LIS coursework. Recommendations for how to expand course offerings in these areas are explored. Overall, these preliminary findings help to map the existing health and social justice curricula and contribute the LIS educator viewpoint for both reducing health disparities and advancing health justice conversations.

As digital natives, young adults have been found to consider themselves to have good information literacy skills, when in fact many do not. Past research indicates that not only do young adults rely heavily on information obtained from the web and social networks, but also that they may not be able to judge the authenticity, validity, and reliability of digital information, and may share misinformation among themselves. This can be particularly problematic in the context of health information. Two complementary research studies investigated young adults’ information needs and information seeking in support of their personal well-being, and in comparison to academic and other everyday-life information domains. Results show that young adults consider a range of factors as part of their well-being; these include physical and mental health, spirituality, social connections, and financial stability. They engage in information seeking (active and passive) in support of all of these factors. While they were able to identify information resources as more or less credible, they did not necessarily choose highly credible resources most frequently. Interestingly, they did not use social media sources frequently in the context of health information, choosing to deliberately maintain a degree of privacy with respect to health. While there is evidence of some information literacy skills, there remains a need for further and more extensive information literacy education. This should be addressed by librarians from academic, consumer health, public, and school libraries.

Research finds that various demographic factors, such as race, gender, education, and income, are associated with disparate health outcomes. Health literacy is an asset that can help consumers exert greater control over their health. The rapidly evolving information landscape can be overwhelming for consumers seeking health information. Users may not be aware of the influence of power, prestige, and money in funding, designing, creating, and disseminating information to consumers. Information professionals have an important role to play in providing health information to their users. Proponents of critical information literacy argue that librarianship must evolve beyond supporting the status quo and assist users in understanding the political and commercial forces that can shape the options available to users. Health-literate individuals can also be empowered to challenge the social determinants of health and support policies that would lead to more significant health equity for the whole of society.

This study sought to explore the needs and challenges of public libraries in meeting their users’ health information needs. The study also investigated participants’ perceptions regarding a public library workshop for consumers on the critical evaluation of health information. The study found that while attendance was low, the attendees rated the workshop positively.

On a world basis, 15% of the population has a disability. Having a disability can result in a higher frequency of health-related information needs than other users might experience. The Web represents a widely used source for health information. People with disabilities, however, often encounter barriers during online searching, such as inaccessible information, poorly designed search user interfaces and lack of compatibility with assistive technology. Consequently, many users are potentially excluded from a range of information sources. Measures are therefore needed to remove these barriers to avoid health disparities that can result from unequal access to information. Public libraries have a social responsibility to include all user groups, and should aspire to make fully accessible services. A good tool in this context is the implementation of the universal design mind-set, where the purpose is to develop services that are available to all people. This chapter discusses how universal design can be a premise for equal access to health information and potentially reduce health disparities in the context of users with disabilities. Both library services and education of librarians will be addressed.

American sex education is continually under fire due to conflicting morals surrounding hegemonic sociocultural norms. These programs, and ultimately the students, are often victims of information inequities which leverage adult control over minors to prevent access to sexual health information. Withholding salient sexual health information infringes on intertwined tenets of human rights, such as education and information access. Spurred by recent disputes and barriers to updating unethical curricula in the states of Arizona and Texas, this chapter uses a human rights lens to explore the current information inequities in K-12 sexual education and students’ precarious positions in policy spaces. This framework demonstrates how libraries are uniquely protected spaces for intellectual freedom and the roles librarians can and should play as sexual health information providers in order to help students overcome information inequities. This chapter will provide recommendations for librarians and other educators to inform and organize advocacy as well as leverage current library operations to support adolescents’ sexual health literacy.

Drug Treatment Courts (DTCs) offer a form of alternative sentencing for people who have been convicted of a crime related to drug or alcohol abuse. The work of rehabilitation in DTCs is client-centered, meaning that it takes into account all of the client’s needs that affect their life in regards to completion of the program and rehabilitation. DTCs employ teams of people made up of judges, lawyers, educators, clinicians, and community supervisors. There are specific ways that librarians might become involved with DTCs regarding both literacy and, more specifically, health literacy. Existing programs could be adapted to solve common health literacy problems of participants, and librarians could also forge relationships with DTCs. Training for librarians should include education about the health and literacy problems faced by this population so they can successfully connect DTC participants with people and information that will contribute to their success completing the program and building healthier lives. This chapter looks to established best practices within DTCs and to some current related programs within public libraries to find grounds for expanding services to this population.

The University of Tennessee Medical Center in Knoxville (UTMC) Preston Medical Library (PML) and Health Information Center (HIC) has provided a novel contribution to increasing consumer health literacy and reducing health disparities in a unique variety of ways. UTMC librarians have used qualitative, quantitative, and practice-based methodology and research to demonstrate what a regional medical library working with internal and community partners can accomplish. At UTMC, there has been a focus on the value of health literacy for the patient, the clinician, and the health care system itself. In 1993, the UTMC PML began a consumer and patient health information service, which was the foundation for increasing consumer health literacy. In 2014, UTMC took a leading role in advancing consumer health literacy through the opening of the HIC, a patient- and family-focused library inside of UTMC. This chapter will focus on the PML’s history as a reliable resource in providing patients, family members, and the community with accurate and trustworthy health information, as well as the librarians’ role related to health literacy and health disparities through various initiatives and projects. Additionally, this chapter will highlight specific suggestions for libraries interested in starting similar initiatives, such as obtaining support from leadership, opportunities for funding, and how to address roadblocks.

While musicians contribute a great deal to the atmosphere of a city like Austin, Texas, they may be poorly compensated for their work. Their low salaries, personality traits, and lifestyle preferences may also mean that musicians may be reluctant to engage in preventative health strategies. Frequently lacking sufficient health insurance, musicians may have difficulty coping with health challenges such as depression and anxiety, hearing loss, poor nutrition, and alcohol and substance abuse.

This chapter opens with background on the music scene in Austin, Texas and moves to a description of a recent study on how musicians feel their careers impact their health. This is followed by a literature review that summarizes what is known about musicians’ personalities, their lifestyles, the economic factors they face, and their health disparities. In the last half of the chapter, the author summarizes how libraries currently serve musicians and add recommendations for how libraries might expand these services.

This project examines how queer and trans zines have complicated the notion of traditional patient narratives and provides insight into the issues that LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning) populations face when accessing healthcare information and resources. Historically, information about queer and trans identities has been suppressed in the United States, reflecting dominant social values that pathologize queer identities. Using health-related zines housed at the Queer Zine Archive Project as a case study, this project investigates how queer and trans zines about healthcare have resisted these homophobic and transphobic ideologies. The analysis reveals that queer and trans zinesters use their feelings of impatience with the medical industry to fuel communal solutions to accessing and providing health care information.

This chapter addresses the shortcomings of current self-efficacy models describing the health information practices of lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) communities. Informed by semi-structured interviews with 30 LGBTQIA+ community leaders from South Carolina, findings demonstrate how their self-efficacy operates beyond HIV/AIDS research while complicating traditional models that isolate an individual’s health information practices from their abundant communal experiences. Findings also suggest that participants engage with health information and resources in ways deemed unhealthy or harmful by healthcare providers. However, such practices are nuanced, and participants carefully navigate them, balancing concerns for community safety and well-being over traditional engagements with healthcare infrastructures. These findings have implications for public and health librarianship when providing LGBTQIA+ communities with health information. Practitioners must comprehend how the collective meanings, values, and lived experiences of LGBTQIA+ communities inform how they create, seek, share, and use health information to engage in successful informational interventions for community health promotion. Otherwise, practitioners risk embracing approaches that apply decontextualized, deficit-based understandings of these health information practices, and lack community relevance.

In this closing chapter, the authors first draw on the contributed chapters in this volume to highlight some of the many ways in which libraries and librarians are moving us closer to health justice by working with their communities to increase consumer health literacy and to decrease health disparities. The authors then focus our attention on the COVID-19 pandemic, discussing the fact that disadvantaged populations are bearing the brunt of the negative impacts of this situation and the many existing and novel roles that libraries and librarians are playing to help to fight consumer health information injustice and to contribute toward better health outcomes for all. Next, Dr Beth Barnett brings her viewpoint as a Board Certified Patient Advocate to the volume, pointing out parallels between the roles of librarians and those of patient advocates, as well as important lessons for patient advocates gleaned from the volume. To conclude the chapter, the authors reiterate our aims for the volume and issue a call to the reader to join libraries and librarians in their important role as agents of health information justice.