Health Literacy

Health literacy is considered a variation of functional literacy, and for that reason, many definitions of health literacy build on the definition of literacy: the ability to read and write and the quality of being knowledgeable in a particular subject or field. The Center for Health Care Strategies (CHCS) significantly extends the definition of literacy by adding the concepts of understanding and action; it defines health literacy as the ability to read, understand, and act on health information. The American Medical Association's (AMA's) Ad Hoc Committee on Health Literacy uses a slightly broader definition; it considers health literacy to be the constellation of skills required to function in the healthcare environment, including the ability to perform basic reading and numerical tasks such as the ability to read and comprehend prescriptions, appointment slips, and other essential health-related materials.

The national Institute of Medicine (IOM), U.S. Department of Health and Human Services (HHS), and the National Library of Medicine (NLM) define health literacy as the degree to which individuals have the capacity to obtain, process, and understand the basic health information and services needed to make appropriate health decisions. Some critics find this definition overly broad because it includes the individual's ability to obtain both health information and services. They argue [Page 515]that the capacity to obtain services is more a function of resources than of literacy.

The World Health Organization (WHO) uses an even broader definition: Health literacy represents the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health. Health literacy means more than being able to read pamphlets and successfully make appointments. By improving people's access to health information and their capacity to use it effectively, health literacy is critical to empowerment. This definition emphasizes that it is not enough for people to have health information; they must also have access to healthcare. The WHO moves healthcare providers beyond providing health information to initiating the process of empowerment so that individuals can become active participants in their own healthcare.

Health literacy exists when health information and services are provided in a manner easily understandable and appropriate for their audience. An individual's health literacy skills depend on his or her culture, education, and language. Equally important are the skills of those who provide health information, such as health workers, the media, the marketplace, and government agencies. To maximize health literacy, it is crucial that those who provide health information and services align their skills, expectations, and preferences with those of the individuals who are seeking health information.