Eliza D. Whiteman, MS, MPH^1,2; Roxanne Dupuis, MSPH²; Anna U. Morgan, MD, MSc, MSHP³; Bernadette D’Alonzo, MPH²; Caleb Epstein²; Heather Klusaritz, PhD^2,4; Carolyn C. Cannuscio, ScD^2,4 (View author affiliations)

Suggested citation for this article: Whiteman ED, Dupuis R, Morgan AU, D’Alonzo B, Epstein C, Klusaritz H, et al. Public Libraries As Partners for Health. Prev Chronic Dis 2018;15:170392. DOI: http://dx.doi.org/10.5888/pcd15.170392.

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Lead author Eliza Whiteman, MS, MPH, answers questions about this study in PCD’s latest edition of PCD Sound Bites.

Abstract

Introduction

Public libraries are free and accessible to all and are centers of community engagement and education, making them logical choices as partners for improving population health. Library staff members routinely assist patrons with unmet health and social needs.

Methods

We used a 100-question, self-administered web survey sent to all library directors listed in the Pennsylvania Library Association database (N = 621), to investigate staff interactions with library patrons to address social determinants of health. We conducted statistical comparisons of quantitative responses and a content analysis of open-ended responses.

Results

Respondents (N = 262) reported frequently interacting with patrons around health and social concerns — well beyond those related to literacy and education — including help with employment (94%), nutrition (70%), exercise (66%), and social welfare benefits (51%). Acute emergencies were not uncommon in Pennsylvania’s public libraries, with nearly 12% of respondents having witnessed a drug overdose at the library in the past year. Most respondents felt that their professional training left them inadequately prepared to assist patrons with health and social issues. Although at least 40% of respondents offered some health programming at their library branch, their offerings did not meet the high level of need reflected in common patron inquiries.

Conclusion

The challenges library staff members experience in meeting their patrons’ information needs suggest opportunities for public libraries to advance population health. Library staff members need additional training and resources and collaboration with public health and health care institutions to respond to community needs through effective, evidence-based public health programming.

Introduction

As centers for community engagement and education, public libraries provide ideal spaces for the transfer of health information, making them logical choices as partners for improving population health. More than 9,000 public library systems across the country (1) host 1.5 billion in-person visits annually (2), exceeding the number of physician office visits by over 50% (3). During those visits, 42% of patrons report using libraries’ digital resources to search for health information (4).

Literacy, a core mission of libraries, is a cornerstone of lifelong health (5,6). Higher literacy, including health literacy, is associated with increased levels of fulltime employment, on-time high school graduation rates, and a twofold reduced risk of uncontrolled diabetes (7–9). Recent research conducted in Philadelphia showed that public libraries often engage in health-related roles that extend beyond circulation of reading materials (10–12). More than a third of inquiries to public librarians include questions about health (13).

Public libraries also serve as places of refuge for vulnerable populations, including people experiencing mental illness, homelessness, immigration challenges, and trauma (12,14,15). Library staff members regularly assist patrons who have unmet health and social needs, but feel ill-equipped to address these patron needs (12). Previous research has focused on librarians’ role in providing disease-specific consumer health information (16); however, little is known from surveys about the extent to which librarians are called on to assist patrons with social determinants of health, such as housing, employment, and education (17).

The objective of our study was to investigate the frequency and methods library staff members use and are familiar with to address the social determinants of health. Our research — one of several steps taken by the Healthy Library Initiative (18) to establish the feasibility of partnering with public libraries to improve population health — can be extended nationally to inform future partnerships between public libraries and the public health sector.”

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