Choosing a healthy lifestyle, knowing how to seek medical
care, and taking advantage of preventive measures require
that people understand and use health information. The
ability to obtain, process, and understand health information
needed to make informed health decisions is known as
health literacy.
Given the complexity of the healthcare system, it is
not surprising that limited health literacy is associated
with poor health. This fact sheet summarizes key research
study findings on the relationship between health literacy
and health outcomes.
Use of preventive services
According to research studies, persons with limited
health literacy skills are more likely to skip important
preventive measures such as mammograms, Pap smears, and
flu shots.1
When compared to those with adequate health literacy
skills, studies have shown that patients with limited
health literacy skills enter the healthcare system when
they are sicker.2
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Knowledge about medical conditions and treatment
Persons with limited health literacy skills are more
likely to have chronic conditions and are less able to
manage them effectively. Studies have found that patients
with high blood pressure,3
diabetes,3-5 asthma,6
or HIV/AIDS7-9
who have limited health literacy skills have less knowledge
of their illness and its management.
Rates of hospitalization
Limited health literacy skills are associated with an
increase in preventable hospital visits and admissions.10-13
Studies have demonstrated a higher rate of hospitalization
and use of emergency services among patients with limited
literacy skills.12
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Health status
Studies demonstrate that persons with limited health
literacy skills are significantly more likely than persons
with adequate health literacy skills to report their
health as poor.10,
12
14
Healthcare costs
Persons with limited health literacy skills make greater
use of services designed to treat complications
of disease and less use of services designed to prevent
complications.1, 11-13
Studies demonstrate a higher rate of hospitalization
and use of emergency services among patients with limited
health literacy skills.10-13
This higher use is associated with higher healthcare
costs.15
16,
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Stigma and shame
Low health literacy may also have negative psychological
effects. One study found that those with limited health
literacy skills reported a sense of shame about their
skill level.17
As a result, they may hide reading or vocabulary difficulties
to maintain their dignity.18
About the research
In producing this fact sheet, the Office of Disease
Prevention and Health Promotion relied extensively
on both the Institute of Medicine (2004) and the
Agency for Healthcare Research and Quality (2004)
reports, which include comprehensive reviews of
the literature on health literacy and health outcomes.
For your convenience, the original studies are
cited.
In these studies, health literacy was measured
by the Rapid Estimate of Adult Literacy (REALM)
or Test of Functional Health Literacy in Adults
(TOFHLA). Both the IOM and AHRQ reports conclude
that REALM and TOFHLA are assessments of reading
ability, and as such are inadequate measures of
health literacy.
Persons with limited health literacy were compared
to those with adequate health literacy. Although
an increasing number of studies have linked limited
health literacy to poor health, the causal relationship
between health literacy and health is unknown. |
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