What is health literacy?
Health literacy is the degree to which individuals have
the capacity to obtain, process, and understand basic
health information and services needed to make appropriate
health decisions.1
Health literacy is dependent on individual and systemic
factors:
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Communication skills of lay persons and professionals
-
Lay and professional knowledge of health topics
-
Culture
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Demands of the healthcare and public health systems
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Demands of the situation/context
Health literacy affects people's ability to:
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Navigate the healthcare system, including filling
out complex forms and locating providers and services
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Share personal information, such as health history,
with providers
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Engage in self-care and chronic-disease management
-
Understand mathematical concepts such as probability
and risk
Health literacy includes numeracy skills. For example,
calculating cholesterol and blood sugar levels, measuring
medications, and understanding nutrition labels all require
math skills. Choosing between health plans or comparing
prescription drug coverage requires calculating premiums,
copays, and deductibles.
In addition to basic literacy skills, health literacy
requires knowledge of health topics. People with limited
health literacy often lack knowledge or have misinformation
about the body as well as the nature and causes of disease.
Without this knowledge, they may not understand the relationship
between lifestyle factors such as diet and exercise and
various health outcomes.
Health information can overwhelm even persons with advanced
literacy skills. Medical science progresses rapidly.
What people may have learned about health or biology
during their school years often becomes outdated or forgotten,
or it is incomplete. Moreover, health information provided
in a stressful or unfamiliar situation is unlikely to
be retained.
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What is literacy?
Literacy can be defined as a person's ability
to read, write, speak, and compute and solve problems
at levels necessary to:
The term “illiteracy” means being unable
to read or write. A person who has limited or low literacy
skills is not illiterate.
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What is plain language?
Plain language is a strategy for making written and
oral information easier to understand. It is one
important tool for improving health literacy.
Plain language is communication that users can understand
the first time they read or hear it. With reasonable
time and effort, a plain language document is one in
which people can find what they need, understand what
they find, and act appropriately on that understanding.3
Key elements of plain language include:
-
Organizing information so that the most important
points come first
-
Breaking complex information into understandable
chunks
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Using simple language and defining technical terms
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Using the active voice
Language that is plain to one set of readers may not
be plain to others.3
It is critical to know your audience and have them test
your materials before, during, and after they are developed.
Speaking plainly is just as important as writing plainly.
Many plain language techniques apply to verbal messages,
such as avoiding jargon and explaining technical or medical
terms.
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What is cultural and linguistic competency?
Culture affects how people communicate, understand,
and respond to health information. Cultural and linguistic
competency of health professionals can contribute to
health literacy. Cultural competence is the ability of
health organizations and practitioners to recognize the
cultural beliefs, values, attitudes, traditions, language
preferences, and health practices of diverse populations,
and to apply that knowledge to produce a positive health
outcome.4
Competency includes communicating in a manner that is
linguistically and culturally appropriate.5
Healthcare professionals have their own culture and
language. Many adopt the “culture of medicine”
and the language of their specialty as a result of their
training and work environment. This can affect how health
professionals communicate with the public.
For many individuals with limited English proficiency
(LEP), the inability to communicate in English is the
primary barrier to accessing health information and services.
Health information for people with LEP needs to be communicated
plainly in their primary language, using words and examples
that make the information understandable.
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Why is health literacy important?
Only 12 percent of adults have Proficient health literacy,
according to the National Assessment of Adult Literacy. In
other words, nearly nine out of ten adults may lack the skills
needed to manage their health and prevent disease. Fourteen
percent of adults (30 million people) have Below Basic health
literacy. These adults were more likely to report their
health as poor (42 percent) and are more likely to lack health
insurance (28 percent) than adults with Proficient health
literacy.6
Low literacy has been linked to poor health outcomes
such as higher rates of hospitalization and less frequent
use of preventive services (see Fact
Sheet: Health Literacy and Health Outcomes). Both
of these outcomes are associated with higher healthcare
costs.
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Who is at risk?
Populations most likely to experience low health literacy
are older adults, racial and ethnic minorities, people
with less than a high school degree or GED certificate,
people with low income levels, non-native speakers of
English, and people with compromised health
status.7
Education, language, culture, access to resources, and
age are all factors that affect a person's health
literacy skills.
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Who is responsible for improving health literacy?
The primary responsibility for improving health literacy
lies with public health professionals and the healthcare
and public health systems. We must work together to ensure
that health information and services can be understood
and used by all Americans. We must engage in skill building
with healthcare consumers and health professionals. Adult
educators can be productive partners in reaching adults
with limited literacy skills.
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