Understanding Health Literacy

Why it's important

Health literacy is important for everyone because, at some point in our lives, we all need to be able to find, understand, and use health information and services.

Taking care of our health is part of everyday life, not just when we visit a doctor, clinic, or hospital. Health literacy can help us prevent health problems, protect our health, and better manage health problems when they arise.

Even people who read well and are comfortable using numbers can face health literacy issues when:

• They aren't familiar with medical terms or how their bodies work.
• They have to interpret statistics and evaluate risks and benefits that affect their health and safety.
• They are diagnosed with a serious illness and are scared and confused.
• They have health conditions that require complicated self-care.
• They are voting on an issue affecting the community's health and relying on unfamiliar technical information.

Why is there a problem?

When organizations or people create and give others health information that is too difficult for them to understand, we create a health literacy problem. When we expect them to figure out health services with many unfamiliar, confusing or even conflicting steps, we also create a health literacy problem.

Limited health literacy vs. limited literacy

Limited health literacy and limited literacy are not the same, but they are related. Strong literacy and numeracy skills help people understand and use health information and services, but research shows that most people say that information and services are unfamiliar, complicated, and too technical.

How we can help

We can help people use the health literacy skills they have. How? We can do the following:

• Create and provide information and services people can understand and use most effectively with the skills they have. See Develop and Test Materials.
• Work with educators and others to help people become more familiar with health information and services and build their health literacy skills over time. See Collaborate.
• Build our own skills as communicators of health information. See Find Training for free, online options.
• Work with trusted messengers to share your information.
  • In many communities, faith leaders are trusted messengers. See the CDC-funded Georgia Nutrition and Activity Initiative's Live Healthy in Faith [6.4 MB, 95 pages] guide for ways to engage members of faith communities in sharing your messages.
  • See Bridging the Gap for ways in which community health workers (also known as promotores) serve as trusted messengers.
• Build health-literate organizations. See the following:
  • Attributes of a Health Literate Organization
  • Assess Health Literacy in Your Organization
  • Organizational Health Literacy: Quality Improvement Measures with Expert Consensus
• Consider the cultural and linguistic norms, environment, and history of your intended audience when developing your information and messages.
• Use certified translators and interpreters who can adapt to your intended audience's language preferences, communication expectations, and health literacy skills.

Resources

Limited health literacy: Reports and evidence

Several reports document that limited health literacy affects many types of health conditions, diseases, situations, and outcomes, including health status and costs.

• Improving Health Literacy Could Prevent Nearly 1 Million Hospital Visits and Save Over $25 Billion a Year [843 KB, 2 pages] and methodology and citations [44 KB, 2 pages] (UnitedHealth Group 2020)
• A Health Literacy Report: Analysis of 2016 BRFSS Health Literacy Data [3.1 MB, 100 pages] (Centers for Disease Control and Prevention 2018)
• Health Literacy Interventions and Outcomes: An Updated Systematic Review (Agency for Healthcare Research and Quality 2011)
• National Action Plan to Improve Health Literacy (U.S. Department of Health and Human Services 2010)
• Surgeon General's Workshop on Improving Health Literacy (U.S. Department of Health and Human Services 2006)
• Health Literacy: A Prescription to End Confusion (Institute of Medicine 2004)
• America's Health Literacy: Why We Need Accessible Health Information [418 KB, 8 pages]: This issue brief summarizes key findings and presents some policy implications of the first ever National Assessment of Adult Literacy (NAAL).

In 2006, the U.S. Department of Education published the only national data on health literacy skills. The study found that adults who self-report the worst health also have the most limited literacy, numeracy, and health literacy skills. See The Health Literacy Of America's Adults: Results from the 2003 National Assessment of Adult Literacy.

The U.S. Department of Education subsequently published 2012/14 and 2017 results on self-reported health status of U.S. adults using data from the Program for the International Assessment of Adult Competencies (PIAAC). These results reinforce the findings of their 2006 report.

European Union countries have found similar health literacy skill issues in the European Health Literacy Survey (Source: Maastricht University 2012).

The following two resources are regularly updated with health literacy research:

• PubMed (National Library of Medicine)
• Roundtable on Health Literacy commissioned papers (National Academies of Sciences, Engineering & Medicine)

Health literacy leaders

Listen to health literacy leaders describe their research and practice in podcasts (Source: Health Literacy Out Loud).