Findings From HSC

Research Brief

NO. 8, OCTOBER 2008

How Engaged Are Consumers in Their Health and Health Care, and Why Does It Matter?
By judith h. hiBBard and peter j. cunningham

Patient activation refers to a person’s ability to manage their health and health care. Engaging or activating consumers has become a priority for employers, health plans and policy makers. The level of patient activation varies considerably in the U.S. population, with less than half of the adult population at the highest level of activation, according to a new study by the Center for Studying Health System Change (HSC) (see Figure 1). Activation levels are especially low for people with low incomes, less education, Medicaid enrollees, and people with poor self-reported health. Higher activation levels are associated with much lower levels of unmet need for medical care and greater support from health care providers for self-management of chronic conditions.

Figure 1 Level of Activation of U.S. Adults, 18 and Older, 2007

Level 1 (least activated) 6.8% Level 2 14.6%

Level 4 (most activated) 41.4%

Level 3 37.2%
Note: Four levels of patient activation have been identified through the Patient Activation Measure (PAM). At Level 1, the least-activated level, people tend to be passive and may not feel confident enough to play an active role in their own health. At Level 2, people may lack basic knowledge and confidence in their ability to manage their health. At Level 3, people appear to be taking some action but may still lack confidence and skill to support all necessary behaviors. At Level 4, the most-activated level, people have adopted many of the behaviors to support their health but may not be able to maintain them in the face of life stressors. Source: HSC 2007 Health Tracking Household Survey

Consumers Key to Health Care Reform Efforts
There is a growing consensus that