HEALTHY COMMUNITIES

ADVANCING HEALTH LITERACY

Individual health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. Nine out of ten American adults don’t have all the literacy skills needed to navigate health diagnoses, plans, and systems. Limited health literacy is linked to poor health outcomes, including increased hospitalizations and higher rates of mortality.

To address this, the Advancing Health Literacy project has created a Health Literacy Train the Trainer Toolkit. This toolkit is intended to increase awareness about and adoption of health literacy best practices among those who share health information with members of the community. We hope to improve the way information is shared and help decrease health disparities, particularly for communities that have been historically excluded from the opportunity to make well-informed health decisions.

Use this toolkit to increase your personal health literacy knowledge and skills, to implement a tried-and-tested health literacy training program, and to increase your organization’s health literacy.

You can access a link to the toolkit at: About the AHL Project for Healthcare Providers | Snohomish County Health Department, WA (snohd.org) (available in English & Spanish).

TUBERculosis

Are You Routinely Testing Patients Who Were Born Outside of The U.S. For Tuberculosis (TB)?  

Nationally, half of all responding health care providers are “Thinking TB” for non-U.S.-born patients according to an MMWR study linked here. Identifying and overcoming barriers to TB recommended testing and treatment is important to prevent disease and achieve TB elimination goals. Anyone born outside of the US or western Europe should be tested for TB at least once. If you find a positive and are unsure about what to do, you can call the health department. Let’s continue to decrease TB transmission in Snohomish County. 

ALWAYS THINK TB 

Consider TB in any adult or pediatric patient with compatible clinical symptoms of:

• Cough that lasts 2-3 weeks or longer  
• Fever 
• Unexplained weight loss  
• Night sweats and/or radiological findings 

BE AWARE OF PEOPLE WITH INCREASED RISK OF INFECTION OR DEVELOPING TB DISEASE, INCLUDING: 

• Close contacts of a person with active TB disease 
• Persons who have history of residence or travel to a place with an elevated TB rate. This includes any country other than the United States, Canada, Australia, New Zealand, or a country in western or northern Europe (Refer to this WHO table for TB-endemic countries and territories. 
• Children younger than 5 years of age who have a positive TB test 
• Persons who have a history of latent tuberculosis infection (LTBI), especially those diagnosed within the past 2 years 
• Persons who have lived or worked in a shelter, correctional facility, long-term care facility or other congregate setting 
• Persons with HIV 
• Persons with diabetes mellitus 
• Persons who are immunocompromised 

TB-ENDEMIC COUNTRIES AND TERRITORIES BASED ON 2019 INCIDENCE PER 100,000 POPULATION: 

• SEVERELY ENDEMIC (500+ NEW AND RELAPSE CASES PER 100,000 POPULATION PER YEAR) 
  • Africa: Central African Republic, Gabon, Lesotho, South Africa 
  • South-East Asia: Democratic People's Republic of Korea 
  • Western Pacific: Philippines 
• HIGHLY ENDEMIC (300–499 NEW AND RELAPSE CASES PER 100,000 POPULATION PER YEAR)
  • Africa: Angola, Congo, Democratic Republic of the Congo, Eswatini, Guinea-Bissau, Liberia, Mozambique, Namibia, Zambia? 
  • South-East Asia: Indonesia, Myanmar, Timor-Leste 
  • Western Pacific: Kiribati, Marshall Islands, Mongolia, Papua New Guinea
• ENDEMIC (100–299 NEW AND RELAPSE CASES PER 100 000 POPULATION PER YEAR) 
  • Africa: Botswana, Burundi, Cameroon, Chad, Côte d'Ivoire, Equatorial Guinea, Ethiopia, Gambia, Ghana, Guinea, Kenya, Madagascar, Malawi, Nigeria, Sao Tome and Principe, Senegal, Sierra Leone, South Sudan, Uganda, United Republic of Tanzania, Zimbabwe
  • Americas: Bolivia (Plurinational State of), Haiti, Peru 
  • Eastern Mediterranean: Afghanistan, Djibouti, Pakistan, Somalia
  • Europe: Greenland, Kyrgyzstan
  • South-East Asia: Bangladesh, Bhutan, India, Nepal, Thailand 
  • Western Pacific: Cambodia, Lao People's Democratic Republic, Micronesia (Federated States of), Nauru, Northern Mariana Islands, Tuvalu, Viet Nam

(Adapted from WHO global list of high burden countries for TB, TB/HIV, and MDR/RR-TB, 2021-2025)

RESOURCES: 

• WA DOH Tuberculosis Resources for Health Care Providers 
• WA DOH TB Surveillance 
• WA Local Health Jurisdictions (LHJs) Contact Information 
• CDC Tools for Health Care Providers 
• National TB Statistics and Surveillance Data