NLM in Focus

What Is Health Literacy?

The National Library of Medicine’s health literacy resources span a spectrum for health literacy practitioners, researchers, and consumers.

A relatively new concept, health literacy’s relevance to better health care was deepened by a 2003 National Assessment of Adult Literacy report, which found 88 percent of Americans either had below basic, basic, or an intermediate understanding of basic medical terms and information.

Similarly, recent results from the Program for the International Assessment of Adult Competencies suggests health literacy may be a social determinant of patient and public health in many nations.

A new perspective from the National Academy of Medicine explains that it is difficult to define health literacy because the field crosses many disciplines.

An international meeting in 2012 provided probably the most comprehensive health literacy definition to date. The Calgary Charter comprised health literacy practitioners and researchers who suggested the following:

  • Health literacy allows the public and personnel working in all health-related contexts to find, understand, evaluate, communicate, and use information.
  • Health literacy is the use of a wide range of skills that improve the ability of people to act on information in order to live healthier lives.
  • These skills include reading, writing, listening, speaking, numeracy, and critical analysis, as well as communication and interaction skills.

The Calgary Charter’s expansive definition reflects 40 years of research and practice, which began with the efforts of health educators Len and Ceci Doak in the 1970s. (Ceci Doak recently donated most of the couple’s papers to NLM.)

Ceci Doak, health literacy pioneer.
(Courtesy of the Institute for Healthcare Advancement)

The field evolved rapidly as 21st century health literacy research found some health literacy interventions were associated with improved patient outcomes and less costly uses of the health care delivery system.

MedlinePlus.gov’s health literacy topic page provides an excellent gateway to other information and resources for newcomers to the field. The page provides numerous links to authoritative resources, including an overview of health literacy from the Centers for Disease Control and Prevention and an explanation of how to read drug labels from the Office on Women’s Health, Department of Health and Human Services.

In addition, MedlinePlus.gov addresses two issues that impact health literacy: understanding medical research and evaluating health information. Both of these health topic pages provide links to evidence-based resources written for general audiences.

PubMed’s offerings, in contrast, are drawn directly from the research-oriented biomedical literature.

Health literacy is one of the areas within PubMed where advanced searching skills are not needed to find relevant results. Instead a curated, topic-specific query about health literacy is available, along with links to relevant reports and websites.

Found on the left side of the PubMed health literacy information page, the preformed health literacy search delivers relevant citations from selected peer-reviewed journals across medicine, public health, and other fields closely aligned with health literacy (including such diverse disciplines as numeracy, health education, communication barriers, and health knowledge). The right side of that page provides direct links to health literacy information from an array of government and non-government sources.

This comprehensive approach makes it uncomplicated to keep up with new research in health literacy even for those without sophisticated PubMed search skills.

Overall, NLM’s resources provide a gateway to understand the health literacy field ranging from overview information to the most advanced research.

By Robert A. Logan, PhD, NLM Senior Staff