Health Literacy
Background
Health Literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions1. The need for a health literate public has become more critical than ever because of rapid innovations in bio-medical sciences, proliferation of information delivery services such as the Internet, cable and satellite TV, steadily increasing the amount of health information in mass media and the Internet, and the movement towards informed and shared decision-making promoting involvement of the patients in medical decisions2-4. These developments have led to an expectation of an informed citizenry, a literate public, which can make intelligent and rational choices about behaviors to stay healthy or to become healthy if one is ill.
Background
Health Literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions1. The need for a health literate public has become more critical than ever because of rapid innovations in bio-medical sciences, proliferation of information delivery services such as the Internet, cable and satellite TV, steadily increasing the amount of health information in mass media and the Internet, and the movement towards informed and shared decision-making promoting involvement of the patients in medical decisions2-4. These developments have led to an expectation of an informed citizenry, a literate public, which can make intelligent and rational choices about behaviors to stay healthy or to become healthy if one is ill.
This normative definition of health literacy requires that a citizen obtain information either through incidental exposure or active seeking, understand it and act on it. Yet, this normative assumption is challenged by the existence of (a) wide disparities in access to and utilization of health services, and in morbidity and mortality among different social classes and racial and ethnic groups5-7and, (b) concomitantly, the documentation of profound inequalities in the distribution of communication services, and in obtaining, processing, learning and acting on information 4,8, 9. That is, the medically underserved are also likely to be underserved in terms of information and communication.
Most of the research to date in the area of health literacy documents the mismatch between literacy demands of the health systems and the literacy skills of the people using the system9. A wide range of literacy skills – reading, writing, oral exchange, and math skills, are necessary to attain literacy but the 1992 National Adult Literacy Survey (NALS) found that 47-51% of adults have limited or low functional literacy-skills10. Researchers have used reading assessment tools such as the Rapid Estimate of Adult Literacy in Medicine (REALM) and the Test of Functional Health Literacy in Adults (TOFHLA) to assess patients’ health-related reading skills and then correlated these readability/literacy levels with poor health outcomes11,12. This body of research has helped to shape the field of health literacy, but more research is required to rigorously examine the full breadth of health literacy as defined by Healthy People 2010 and the IOM. This definition goes beyond one’s ability to read and identify health terms; it speaks more to one’s ability to access health information, effectively navigate the information to retrieve relevant information and then ultimately act on this information.
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