Health literacy is the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment. There are multiple definitions of health literacy, in part because health literacy involves both the context (or setting) in which health literacy demands are made (e.g., health care, media, internet or fitness facility) and the skills that people bring to that situation. Since health literacy is a primary contributing factor to health disparities, it is a continued and increasing concern for health professionals. The 2003 National Assessment of Adult Literacy (NAAL) conducted by the US Department of Education found that 36% of participants scored as either "basic" or "below basic" in terms of their health literacy and concluded that approximately 80 million Americans have limited health literacy. These individuals have difficulty with common health tasks including reading the label of a prescribed drug. Several factors may influence health literacy. The following factors have been shown to strongly increase this risk: age (especially patients 65 years and older), limited English language proficiency or English as a second language, chronic conditions, less education, and lower socioeconomic status. Patients with low health literacy understand less about their medical conditions and treatments and overall report worse health status. Patients who struggle with substantial health literacy challenges often forego important health care such as vaccinations or annual screenings, and are more likely to miss appointments, misuse medication, prepare improperly for procedures, and even die prematurely. Various interventions, such as simplifying information and illustrations, avoiding jargon, using "teach-back" methods, and encouraging patients' questions, have improved health behaviors in persons with low health literacy. The proportion of adults aged 18 and over in the U.S., in the year 2010, who reported that their health care providers always explained things so they could understand them was about 60.6%. This number increased 1% from 2007 to 2010. The Healthy People 2020 initiative of the United States Department of Health and Human Services (HHS) has included health literacy as a pressing new topic, with objectives for improving it in the decade to come. In planning for Healthy People 2030 (the fifth edition of Healthy People), HHS issued a "Solicitation for Written Comments on an Updated Health Literacy Definition for Healthy People". Several proposals address the fact that "health literacy is multidimensional", being the result of a concerted effort that involves the individual seeking care or information, providers and caregivers, the complexity and demands of the system, and the use of plain language for communication.
Definition
The National Library of Medicine defined health literacy as:
"The degree to which individuals have the capacity to obtain, process, and understand basic health literacy information and services needed to make appropriate health decisions." Health literacy encompasses a wide range of skills, and competencies that people develop over their lifetimes to seek out, comprehend, evaluate, and use health information and concepts to make informed choices, reduce health risks, and increase quality of life. Another view of health literacy includes the ability to understand scientific concepts, content, and health research; skills in spoken, written, and online communication; critical interpretation of mass media messages; navigating systems of health care and governance; knowledge and use of community capital and resources; and using cultural and indigenous knowledge in health decision making. This view sees health literacy as one of the social determinants of health which can reduce inequities in health.
Impact Health literacy influences individuals' ability to obtain, understand, and use health information, which in turn affects their ability to make informed to make health decisions, and thus directly addresses health inequalities. Individuals with lower levels of health literacy live, disproportionately, in communities with lower socio-economic standing. A barrier to achieving adequate health literacy for these individuals is a lack of awareness, or understanding of, information and resources relevant to improving their health. This knowledge gap arises from both people being unable to understand information presented to them and clinical sources providing inadequate resources to address these literacy gaps. Inadequate health literacy can lead to misunderstanding medical instructions, medication errors, missed appointments, and other adverse health outcomes. The levels of health literacy are considered adequate when the population has sufficient knowledge, skills, and confidence to guide their own health, and people are able to stay healthy, recover from illness, and live with disability or disease.
Lower literacy Health literacy influences a person's ability to understand medical information, such as prescription instructions and treatment recommendations, which can directly affect their ability to follow medical advice and manage their health effectively. Research shows that people with low health literacy may not understand medication instructions or dosage information, which can lead to medication errors and poor treatment outcomes. People with lower health literacy are also more likely to use emergency healthcare services and experience difficulties navigating healthcare systems — this means more emergency room visits, more hospitalizations, and higher healthcare costs. Health literacy also affects communication between people and healthcare providers, not only when it comes to prescription and treatments, but in the ability of people needing care to ask questions, participate in decision-making, and understand medical advice, which in turn influence health outcomes. Further, limited health literacy is associated with lower participation in preventive healthcare behaviors, including cancer screening, vaccinations, and early medical consultation. These lower rates of preventive behaviors and delayed medical care can negatively affect health outcomes.
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