Research and Evaluation | Noteworthy Practices | Additional Links

Health Literacy is often defined as the ability to read, understand, and act upon health-related information. Many adults with low literacy have difficulty reading and understanding directions for taking medications, do not know how to complete medical consent forms, have problems with the intricacies in accessing health care for themselves and their families, as well as dealing with a variety of other health-related issues. Health Literacy involves more than just the ability to read and understand words and procedures associated with health care. It involves comprehension, communication, and appropriate action. There are both direct and indirect consequences of low health literacy. Direct effects include non-compliance or medication errors. The indirect effects are harder to measure, but may include insurance issues, accessibility to health care, and poor health behavior choices.

Advancement in the quality of health communication may result in more cases of early detection and preventive care, increased use of health services and adherence to medical regimens, and a better understanding of the health care system, as well as individual rights and responsibilities. Ultimately, improving health literacy may improve the health status and quality of life of America's adults, especially among adults with marginal literacy skills.

Research and Evaluation

• The health literacy component of the 2003 National Assessment of Adult Literacy (NAAL) is the first national assessment designed to measure adults' ability to use literacy skills to read and understand health-related information. Released on September 6, 2006, it is sponsored by the National Center for Education Statistics (NCES), U.S. Department of Education. NAAL is a nationally representative assessment of English language literacy skills of Americans age 16 and older.
• The Agency for Healthcare Research and Quality (AHRQ), under its evidence-based practice program, developed scientific information for other agencies and organizations on which to base clinical guidelines, performance measures, and other quality improvement tools. There are several categories on this site that can provide additional information.
• The Journal of the American Medical Association (JAMA) produces many articles and is well respected for its rigorous research criteria in the field of medicine. Original research articles and reviews are complimentary for registered guests 12 months after publication. There are several articles or abstracts that can be printed concerning health literacy.
• The New England Journal of Medicine (NEJM) is a weekly general medical journal that publishes new medical research findings, review articles, and editorial opinion on a variety of medical topics. While its articles cost $10 each, you may register for a complimentary copy of an article if it was published more than six months before your request. See The Silent Epidemic — The Health Effects of Illiteracy PDF (76KB)

Noteworthy Practices

• The Massachusetts Department of Education established the System for Adult Basic Education Support (SABES) in 1990. The Health Literacy site contains information about the fields of health and adult basic education, including information about English language learners. It provides hands-on resources to help strengthen those links through learner-centered work.

• The U.S. Department of Health and Human Services launched Healthy People 2010 as a ten-year project. The initiative is a comprehensive, nationwide health promotion and disease prevention agenda. Healthy People 2010 contains 27 objectives. Objective 11 is Health Communication.

Additional Links

• LINCS is a service of the National Institute for Literacy (NIFL) and is a collection of resources and discussions. You may register to join the Health Literacy Discussion list.

• The American Medical Association's (AMA) foundation has been interested in Health Literacy since the late 1990s. Check its Web site for articles written for physicians that deal with Health Literacy. This site has sub-sites such as Health Literacy News. Register for its complimentary Health Literacy newsletter. Another source is the AMA's amednews.com.

• American Medical Association's medical library offers a wealth of information. Parents may access this site for information about their children's health. One can access other areas of information. For instance, Smart Parents´ Health Source newsletter is provided free of charge.

• Brochures from the U.S. Food and Drug Administration that represent easy-to-read health information available in both English and Spanish for patients. "To Err Really is Human: Misunderstanding Medication Labels" PDF (1,391KB) is an informative slide presentation.

• Health Literacy Studies (HLS) at the Harvard Public School of Health is a research program of the National Center for the Study of Adult Learning and Literacy (NCSALL). Its work is based in public health, health care settings, and adult education programs. The site has a new posting of Research and Policy. Click on some of its other categories, such as, Health Literacy Literature, and Innovative Materials.

• The Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services, has several Web sites dedicated to Health Literacy. This one contains publications that discuss patient-physician communication, low literacy skills of patients and its possible effects on using prescriptions inappropriately.