Tips For Identifying And Addressing
Health Literacy Issues

Low health literacy can prevent patients from understanding their health care services.

Health Literacy is defined by the National Health Education Standards (*) as "the capacity of an individual to obtain, interpret, and understand basic health information and services and the competence to use such information and services in ways which are health-enhancing."

This includes the ability to understand written instructions on prescription drug bottles, appointment slips, medical education brochures, doctor's directions and consent forms, and the ability to negotiate complex health care systems. Health literacy is not the same as the ability to read and is not necessarily related to years of education. A person who functions adequately at home or work may have marginal or inadequate literacy in a health care environment.

Barriers to Health Literacy
  • The ability to read and comprehend health information is impacted by a range of factors including age, socioeconomic background, education and culture.
  • Example: Some seniors may not have had the same educational opportunities afforded to them.
  • A patient’s culture and life experience may have an effect on their health literacy.
  • Example: A patient’s background culture may stress verbal, not written, communication styles.
  • An accent, or a lack of an accent, can be misread as an indicator of a person’s ability to read English.
  • Example: A patient, who has learned to speak English with very little accent, may not be able to read instructions on a prescription bottle.
  • Different family dynamics can play a role in how a patient receives and processes information.
  • In some cultures it is inappropriate for people to discuss certain body parts or functions leaving some with a very poor vocabulary for discussing health issues.
  • In adults, reading skills in a second language may take 6–12 years to develop.
Possible Signs of Low Health Literacy

  • Your patients’ may frequently say:
  • I forgot my glasses.
  • My eyes are tired.
  • I’ll take this home for my family to read.
  • What does this say? I don’t understand this.
  • Your patients’ behavior may include:
  • Not getting their prescriptions filled, or not taking their medications as prescribed.
  • Consistently arriving late to appointments.
  • Returning forms without completing them.
  • Requiring several calls between appointments to clarify instructions.

Tips for Dealing with Low Health Literacy

  • Use simple words and avoid jargon.
  • Never use acronyms.
  • Avoid technical language (if possible).
  • Repeat important information – a patient’s logic may be different from yours.
  • Ask patients to repeat back to you important information.
  • Ask open-ended questions.
  • Use medically trained interpreters familiar with cultural nuances.
  • Give information in small chunks.
  • Articulate words.
  • “Read” written instructions out loud.
  • Speak slowly (don’t shout).
  • Use body language to support what you are saying.
  • Draw pictures, use posters, models or physical demonstrations.
  • Use video and audio media as an alternative to written communications.

(*) Joint Committee on National Health Education Standards, 1995

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Health Literacy Issues

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Last updated on 11/9/2010