A Book a Day Keeps the Doctor Away!

By Justine Achille

Not exactly the phrase we’re used to hearing— but reading one book per day might be just what the doctor prescribed for our DC Reads tutees. Living in a society where the majority of adults are functionally illiterate* leads to low expectations for the future generations and unfortunately, it has also been proven to lead to decreased life expectancy. *(Do not possess the reading/comprehension skills necessary to fill out simple forms such as a job application.)

It may seem strange that the ability to read and understand what you are reading can be tied to your health—but it turns out that there is a direct correlation between literacy and wellbeing. Up to a certain degree, the more literate you are, the healthier you will likely be. But why is this so?

 It all comes down to the definition of health literacy. According to HHS Healthy People 2020, health literacy is “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needs to make appropriate health decisions.” 

To get a better glimpse at what it might be like to be have very low literacy try reading the following passage that was presented to my Health Promotion and Disease Prevention class: 

GNINAELC – Ot erussa hgih ecnamrofrep, yllacidoirep naelc eht epat sdaeh dna natspac revenehw uoy eciton na noitalumucca fo tsud dna nworb-red edixo selcitrap. Esu a nottoc baws denetsiom htiw lyporposi lohocla. Eb erus on lohocla sehcuot eht rebbur strap, sa ti sdnet ot yrd dna yllautneve kcarc eht rebbur. Esu a pmad tholc ro egnops ot naelc eht tenibac. A dlim paos, ekil gnihsawhsid tnegreted, lliw pleh evomer esaerg ro lio.

(The American Medical Association Foundation & American Medical Association considers this a simulation of how someone who is “non-literate in English” would view a printed page)

It’s difficult, isn’t it?—especially if there is the occasional misspelled word. Well what if I asked you some questions about that paragraph—such as: what color should the particles on the tapehead be when you clean it?—would you be able to answer? Did you even know that this paragraph is about cleaning tapeheads? Do you know what that means? Well now imagine you are a third-grader from Ward 8, twenty years in the future. You are at a doctor’s office reading about a procedure you need to get to stop the horrible headaches you’ve been having—but unfortunately, you read at a first-grade level. That consent form you are reading is going to look a lot like the paragraph above, and chances are you won’t understand the majority of it. 

This scenario occurs every day throughout America. Patients who cannot read at their age-level fail to understand information that is critical to their health. This results in missed appointments, incorrect use of medicine, and potentially death.

To give another example of a common problem in health literacy read the following phrase that is often put on brightly colored labels on medicine bottles: 

MEDICATION SHOULD BE TAKEN WITH PLENTY OF WATER

This sentence was determined to be at a fourth-grade reading level—about the age of our DC Reads tutees. While it was estimated that a little under two-thirds of people at a fourth-grade reading level would be able to understand this label, in reality only a little over one-third of people at a sixth-grade reading level could understand this. **

Clearly, without good literacy we are setting the future generations up for failure—and potentially poor health. Remember that DC Reads is more than a tutoring program; we are an organization that prepares the youth for success in all areas of life—keeping to the cura personalis motto of Georgetown.

Next time you are at a doctor’s office filling out forms, take note of how many times you cannot understand exactly what is being asked of you, and then reflect on what it must be like to try to read that same form at the reading level of a third-grader.

** Information presented here reflects data found by UNC Program on Health Literacy. See http://www.nchealthliteracy.org/ for more information.

Program Snapshot: Afternoons in the 3rd grade

We have four different tutoring programs within DC READS: our traditional one-to-one after-school tutoring for third graders; Saturday tutoring at libraries and community centers; morning tutoring, where we serve as de-facto teachers' assistants in classrooms for all the different elementary school grades; and then our 4th and 5th grade program, which functions as an after-school classroom run by a group of tutors and coordinators and focuses on personal development goals, writing, vocabulary, and other forms of student enrichment. Over the course of this year, we'll be posting a mixture of tutor and coordinator reflections to allow us to convey our experience as educators and mentors, while also filling our readers in on exciting developments within each of our programs.

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The following post was written by Justine Achille, a sophomore in the NHS who is currently tutoring at Kenilworth Elementary School:

The session was going to go great. I knew it. I had printed out a vocabulary activity that I made up that I knew my tutee would enjoy, and I was bringing the white board. I didn’t really have a plan as to what to do with it, but that didn’t matter. As a rule, all tutees love using white dry-erase boards, and mine is no exception. So in my mind, the day was going to be a hit, without a doubt, and at first, everything was going just as planned. We ambled through a book about a nice woman who owned “The Strawberry Inn,” and then we began to tackle my vocab worksheet.

Outside of Kenilworth Elementary

First, I should probably back-track and explain that my tutee has been obsessed with the idea of “creating a community.” When I first heard this I was completely blown away. My tutee, this little third grader, is thinking of ways to build a good community! So I asked her how she would go about doing this, excited about what kind of insight she might have about the workings of a community or town. Her reply was something along the lines of: well… we could use milk cartons…and construction paper….and…Of course. She means literally, let’s build a community. I have to say, I should have probably expected this. But nonetheless, I decided to try to work with the idea. 

Thus the vocab worksheet was full of words describing either components of a good community, or those of a bad one. Her job was to read the words, try to understand their meanings, and decide if they should be part of this imaginary community. Wanting to challenge her, I threw in some words that I knew she would not recognize, but I hoped that together we could define them, and then she could learn their meanings. The first words we came to were “GREEN SPACE,” as in parks or something of the sort; the word was circled. Perfect. Next was “SIDEWALKS,” again, circled. Great. Then we got to “LAW ENFORCEMENT”; I expected that she might not know the meaning of this one immediately, so I was prepared for her pause. She began to read the word out loud. “Law,” she said confidently, and then stopped. I gave her another second to think, but instead of moving on, she looked to me. I then began with the old standby: now, let’s try to sound it out. And so we did. Or, I should say, I did.

We began with the very first letter: e. What sound does the “e” make? She excitedly responded with “Eh! Eh! Eh!” Correct. We moved on. The “n” to my surprise, made the “Mmmm mmmm” sound. Close. But not quite. After a quizzical look up at me, I gave in. It makes the “Nuh nuh nuh” sound, I confessed. Unfortunately, the rest of the word followed in a manner much like the “n.” Without wanting to lose the whole purpose of the activity, I shook if off, chalking up her mistakes to unfamiliarity with the new word, and we began to try to dissect its meaning. Thankfully, after finding the word “force” hidden in there, we were able to come to the definition rather quickly. I think both my tutee and I were a little wary to continue, given the amount of errors we encountered with “LAW ENFORCEMENT,” but nonetheless, we proceeded cautiously through the activity. After a lot more help on my part than I had originally anticipated, we finished, and I came to a decision about how we should use the white board that day: we would review phonics.

I started by writing the letter “D” on the board and asking her to give me the sound or sounds it makes and a word that begins with that letter. Without hesitation she complied. To make it fun, I let her take a turn and quiz me – tutees seem to love feeling like they are controlling the game. She gave me a letter and then we switched back. The game continued smoothly, building her self-confidence and my confidence in her. However, when we got to “c,” things got rocky again. I know “c” is tough; who would expect it to sometimes be an “s” in disguise? Certainly not me! But nonetheless, it is something that every child needs to learn to recognize eventually. When I pushed for a second sound that this letter might make, she began guessing at random, giving me any sound she knew. With a slow nod of resignation, I once again gave in and made the sound for her.

We moved on to vowels, and to my surprise, it was “long” vowel sounds that seemed to trouble my tutee the most. She stared at the large round “O” I had written on the board, and as the seconds went by, I closed my eyes a moment and just hoped that she would come up with the right sound. She had already done the hard part and given me the short “o” at the beginning of “octopus,” but as I continued to press: and what sound does the second “o” in octopus make? I received nothing but blank stares. She finally smiled and said “ohhh! I know!” Yes, yes yes! That’s exactly right! But wait, she wasn’t finished: “ohhh! I know!” she said, “It’s the puh puh puh sound!”

I froze, and prayed that my face was not betraying my true emotions.

I was crestfallen in the truest sense of the word. I, of course, had thought her original exclamation was her answer. As she continued to smile up at me, looking completely pleased with herself, I couldn’t speak. This beautiful, enthusiastic eight year-old girl does not know the sounds of the alphabet. Dumbstruck I just sat there for a moment, but the longer I waited, the more confused she was getting, and the angrier I became on the inside. How could her school have let her move on to the third grade without making sure she knew the sound of every letter of the alphabet? How could they let such a devastating learning deficit slip through the cracks? What teacher, who spends two hundred-odd days of the year with her, had not spotted this problem, which I had picked up on in only my fourth hour of knowing her? She is in the third grade! I was appalled and outraged and frustrated and more than anything else, deeply saddened by my discovery. 

Not knowing what else to do, I slapped a smile back on. Close, I told her, let’s try it again. The day certainly was not a hit. By the end of the session my tutee was visibly dejected as one can only be from trying and failing time after time after time. Hey, I said, you did a great job today. I held out my hand, our cue for our secret handshake. Slowly, she looked up, and seeing my gesture, a smile spread across her face. At the end of that long day, I couldn’t help but feel a new sense of urgency in my position as a tutor. It’s tough days like these that make me realize how the DC public school system struggles to serve their youth, but it is smiles like the one I saw on my tutee’s face that remind me that what I can do, even though it may not be much, is enough to make a difference. This is why I tutor.