The ability to obtain and understand basic health information and health care services is

Índice Show

What is health literacy?
The importance of health literacy
Health literacy during a global pandemic
How to improve health literacy
Practical steps to improve your own health literacy
Health literacy: Moving from individual health to community well-being
Who Has Limited Health Literacy Skills?
Why Is Health Literacy Important?
How Can We Address Health Literacy?
How does NNLM support Health Literacy?
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Technology Outreach to Reduce Health Disparities and Stigma

Have you ever found yourself up late, feeling sick and searching online for home remedies? If yes, you know the difficulties in navigating medical information. Even a regular check-up at your clinic can mean sifting through a variety of terminology surrounding a new diagnosis or medication. The reality is that healthcare and medicine are complex fields, with new research and protocols being added every day. Doctors and nurses with the best training and excellent communication skills can easily overload a patient who lacks experience and perspective when it comes to disease, prognosis and treatment.

That’s because the expertise medical providers offer is ideally paired with patients who are prepared and empowered when it comes to their health. This is where the concept of “health literacy” enters the picture.

What is health literacy?

“Simply put, health literacy is how we receive, interpret and act on health information,” says Akeia Blue, health communications consultant at Be Health Literate.

Blue offers some examples of how health literacy skills apply to real-world situations.

“A person may not understand essential things such as how and when to take a prescribed medication, how to know when it is appropriate to go to the emergency room rather than a primary care doctor or how to explain signs and symptoms they are experiencing,” Blue explains.

The Centers for Disease Control and Prevention (CDC) officially defines health literacy as the ability to “obtain, communicate, process and understand basic health information and services.”1 Just like reading literacy gives you skills to understand and use written information, health literacy refers to the skills you need to understand and make good decisions about your health.

But these skills aren’t just important on an individual level. Parents, caregivers and many others are tasked with medical decision-making that goes beyond their own personal concerns. Organizations must also make health literate choices, says Beth Hoffman, a Ph.D. candidate at the University of Pittsburgh Graduate School of Public Health.

Hoffman cites the Healthy People 2030 initiative from the U.S. Department of Health and Human Services as key in shaping broader institutional perspectives.

“Healthy People 2030 defines organizational health literacy as the degree to which organizations equitably enable individuals to be health literate,” Hoffman explains.

The importance of health literacy

You might ask the question: isn’t it the doctor’s job to make healthcare decisions? But the most effective healthcare decisions are collaborative. When there are communication barriers, that collaborative ability breaks down.

“Everyone needs health literacy skills to successfully find and access care, prevent certain health conditions, effectively manage those that occur, communicate their needs, understand their choices and make informed decisions,” says Deann Jepson, senior program director at Advocates for Human Potential.

Health literacy skills allow patients to take control of their own well-being by making smart healthcare choices, improving their communication with doctors and equipping them with information to advocate for themselves in a medical setting.

Health literacy during a global pandemic

A lack of health literacy can have consequences, not just on a patient’s personal health, but on the public’s health as a whole. The COVID-19 pandemic has been a clear example of how these skills have very high stakes.

“The COVID-19 pandemic has highlighted the ways in which low levels of health literacy—due to systemic inequities—exacerbate health inequities experienced by people from minority and disadvantaged communities,” says Hoffman. “For example, many people found themselves having to navigate telemedicine appointments for the first time or trying to find credible online resources to get information about COVID-19 vaccines.”

Hoffman also cites the difficulties many faced in signing up online for vaccination appointments as evidence for needing a greater understanding of telemedicine and digital health literacy.

“That was difficult, for even the most health-literate people,” Hoffman says.

From a public health perspective, reduced health literacy can lead to widespread consequences, even in non-emergency situations.

“Low health literacy is also costly for the country,” Blue says. “Because when people don't understand health information and instructions, they are more likely to have worse health outcomes and unnecessarily use emergency room services.”

How to improve health literacy

Experts agree that health literacy is vital to reducing healthcare costs and improving public health. The path to improving health literacy isn’t always straightforward, however. One basic reason for this? Sick people are, by definition, not performing at their best.

“It can be more challenging to be health literate when we are sick or in pain,” Blue explains. “So even someone who normally has a high level of health literacy may struggle at times to understand and process health information.”

The National Action Plan to Improve Health Literacy recommends healthcare professionals use the “Universal Precautions Approach.” This approach assumes all patients have a limited understanding of the procedures and information, requiring professionals to provide clear explanations and instructions using simplified language and videos.

“When people receive accurate, easy-to-understand information, they are better equipped to take care of their health and wellness,” Jepson says.

Hoffman believes building partnerships with existing community institutions, like libraries or faith organizations, is another effective way to promote health literacy

“We need to be teaching kids in schools, as well as making sure older adults have the tools they need to navigate our increasingly digital world,” Hoffman says.

Practical steps to improve your own health literacy

Community programs help improve health literacy nationally, but there are also steps you can take to make health literacy a priority.

“One of the best things to do is ask questions from trusted, reputable sources,” Hoffman says. Asking healthcare professionals questions during clinic visits is good practice in empowering yourself about your own health.

“If they don’t explain it in a way that you can understand, keep asking questions or get a second opinion, if possible,” Hoffman adds.

Blue suggests patients write down any questions or concerns you have for providers ahead of the appointment, as well as recording the appointment or taking notes so you can easily refer back to the doctor’s instructions.

“Another good strategy is to repeat all information back to your healthcare provider, in your own words, to make sure that you understand,” Blue advises. This gives the provider an opportunity to correct any miscommunications on the spot. This isn’t the time to put up a front of false confidence—speak up if you’re not quite following what they’re saying.

In addition, if you’re feeling intimidated about a doctor appointment or worried you might miss something, Blue suggests bringing support.

“It is also appropriate to bring a trusted person to the appointment to listen in,” Blue says. This could be a family member or friend, a home health nurse or a patient care coordinator.

Health literacy: Moving from individual health to community well-being

Once your eyes have been opened to the importance of health literacy, it might just permanently change the way you think about healthcare and the challenges facing those looking to improve health outcomes at a broader scale. Learn more about how public health initiatives affect you and your community in our article “What Is Community Health and Why Is It Important?”

1Centers for Disease Control and Prevention, Health Literacy Basics [accessed December 2021] https://www.cdc.gov/healthliteracy/learn/index.html

An Introduction to Health Literacy

According to the U.S. Department of Health and Human Services’ (HHS) Healthy People 2030 initiative, health literacy involves the information and services that people need to make well-informed health decisions. There many aspects of health literacy:

Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. Examples of personal health literacy include understanding prescription drug instructions, understanding doctor’s directions and consent forms, and the ability to navigate the complex healthcare system.
Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. Examples of organizational health literacy include simplifying the process to schedule appointments, using the Teach-Back method to ensure patient comprehension, and providing communications in the appropriate language, reading level and format.
Digital health literacy, as defined by the World Health Organization, is the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. Examples of digital health literacy include accessing your electronic health record, communicating electronically with your health care team, ability to discern reliable online health information, and using health and wellness apps.
Numeracy, also known as quantitative literacy, refers to a set of mathematical and advanced problem-solving skills that are necessary to succeed in a society increasingly driven by data, as defined by the National Association of Secondary School Principals. Examples of Numeracy include understanding nutrition information, interpreting blood sugar readings, taking correct dosage of medication (ex. take one capsule twice a day), evaluating treatment benefits and risks, and understanding insurance costs and coverage.

Who Has Limited Health Literacy Skills?

Nearly 9 out of 10 adults struggle with health literacy. Even people with high literacy skills may have low health literacy skills in certain situations. For example, someone who is stressed and sick when they’re accessing health information may have trouble remembering, understanding, and using that information.

Why Is Health Literacy Important?

Health literacy involves more than reading — it also includes specific skills, like calculating the right dose of a medicine, following directions for fasting before a surgery, or checking a nutrition label to make sure an item is safe for someone with a food allergy. People with low health literacy skills may have trouble doing these things.

People with low health literacy skills are more likely to:

Have poor health outcomes, including hospital stays and emergency room visits
Make medication errors
Have trouble managing chronic diseases
Skip preventive services, like flu shots

People with higher health literacy skills are more likely to make informed health decisions. That means they’re more likely to be healthy — and even to live longer.

How Can We Address Health Literacy?

Communicating clearly with people helps them find and understand health information. And when people understand health information, they can make well-informed health decisions.

We can also consider taking these steps to address health literacy:

Ensure that people in the community can easily access the health information they need
Create and provide plain language health materials in different languages
Provide trainings to teach health professionals and others who provide health information about health literacy best practices
Create clearinghouses of information about health literacy for health professionals
Review health materials (like insurance forms and medication instructions) with community members to help make sure they understand the information — and what actions they need to take

You can find more information about Health Literacy in MedlinePlus. To find journal articles about Health Literacy, you can use the MEDLINE/PubMed health literacy search to retrieve citations to English language journal literature.

How does NNLM support Health Literacy?

Training. The Network of the National Library of Medicine offers training for those who provide health information to the public such as our On Demand Health Literacy Class. Many of our trainings support the understanding of health literacy and its effects on health while others help professionals gain needed skills to address health literacy in their communities.

Resources. NNLM creates and promotes resources that can support network members in improving the health literacy of their communities. These resources include:

Clinical Conversations is a training program for clinicians about health literacy and related concepts. This program allows clinical trainers or managers to offer brief trainings embedded into existing meetings or trainings as a way to offer continuing education that does not take time out of already busy schedules.
Engage for Health is program is available for libraries, community and faith based agencies and health care providers to offer in their communities. The program consists of tools to conduct a community education program on taking an active role in health care and patient-doctor communication.
Project SHARE is a program developed by the University of Maryland Health Sciences and Human Services Library and funded by the National Library of Medicine. Project SHARE aims to build high school students' skills to reduce health disparities at the personal, family and community level. Module II of the curriculum focuses on health literacy.
Digital Health Literacy Tools from NNLM and All of Us in partnership with the Public Library Association (PLA) and Wisconsin Health Literacy aim to reach people on the other side of the digital divide. These tools help people gain the digital literacy skills needed to access and evaluate health information online and to participate in the All of Us Research Program (All of Us).
Evaluating Internet Health Information: A Tutorial from the National Library of Medicine and MedlinePlus teaches people how to evaluate a variety of sources on the internet to determine how to find reliable sources. This also teaches people how to make proactive decisions about their health.

Funding. NNLM’s Regional Medical Libraries offer grant funding in their respective regions. Funded projects often address health literacy by linking members of the community with quality health information resources and providing training on their use. Other projects address health literacy by offering training to information professionals, healthcare providers or other health professionals about how to support and address health literacy in their communities. Select projects are highlighted in the videos below. More information about funding, including additional previously funded projects is available on NNLM’s funding page.