Center for Health Literacy Promotion - Action research for effective use of health info & services
Health Literacy Definitions

A pressing challenge for heath literacy research and intervention planning is lack of agreement on a definition. As the concept evolves, operational definitions can be viewed in two categories.  

Health Literacy as a Risk
In the U.S., most health literacy research is done in academic medical centers with a clinical orientation that focuses on low health literacy as a cognitive deficit in patients that clinicians need to overcome. This perspective is based on a narrow view of literacy as basic individual skills (reading and numeracy) that are transferrable to any context, including healthcare. This equates health literacy to reading ability in a medical setting. More recently, research has recognized that systemic factors in healthcare, in combination with individual skills, determine a person’s health literacy.

Health Literacy as a Personal & Community Asset
The Center for Health Literacy Promotion uses the concept of health literacy found primarily in the international public health literature. This socio-cultural perspective focuses on health literacy as a personal and community asset that can be developed through health promotion methods: health education and skills development with direct assistance to personal information and apply it in context. In this broader view, health literacy extends beyond the clinical encounter into communities and homes. This conceptualization of health literacy is based in a contemporary view of multiple functional literacies in which literacy involves an array of basic, interactive (social) and reflective (critical) skills, which always are used for practical purpose and enable a person to function in some social arena. Health literacy is used to manage health and healthcare, or said another way to function in the health arena.

Following is a collection of definitions of health literacy, starting with our preferred broader definition from the World Health Organization, followed by the most commonly used official definitions and less commonly used definitions from organizations, individuals, and the media.  Finally, find a listing of related terms with their definitions. The intent is to provide a cross-silos view and invite reflection on what health literacy means to you in your work with your constituents. 

Health literacy is a combination of skills needed to become and stay healthy, to prevent and manage disease. 

Health literacy has two foci—1) the ability of individuals to get, understand and use health information and services; and 2) the extent to which health environments support people as they seek, receive and use information and services. 

Horowitz Center for Health Literacy U of MD 

Add a definition. Send us the definition with the source.

The World Health Organization’s Health Promotion Glossary says: Health Literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health.

Health literacy implies the achievement of a level of knowledge, personal skills and confidence to take action to improve personal and community health by changing personal lifestyles and living conditions. Thus, health literacy means more than being able to read pamphlets and make appointments.

By improving people’s access to health information, and their capacity to use it effectively, health literacy is critical to empowerment. Health literacy is itself dependent upon more general levels of literacy. Poor literacy can affect people’s health directly by limiting their personal, social and cultural development, as well as hindering the development of health literacy.

NewHealth Literacy definition: the process of accessing health information and using it to stay healthy.

Source: Harris J, Springett J, Booth A, et al. (2015).  Can community based peer support promote health literacy and reduce inequalities? A realist review. Public Health Res;3(3) DOI: 10.3310/phr03030

Healthy People 2010 defines health literacy as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

Health Resources and Services Administration uses a similar definition:
... the degree to which individuals have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions and services needed to prevent or treat illness.

The Patient Protection and Affordable Care Act of 2010 Title V also uses a definition drawn from Healthy People 2010:  
... the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.

The National Network of Libraries of Medicine adds:
Health literacy includes the ability to understand 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 simply the ability to read. It requires a complex group of reading, listening, analytical, and decision-making skills, and the ability to apply these skills to health situations.

Health literacy varies by context and setting and is not necessarily related to years of education or general reading ability. A person who functions adequately at home or work may have marginal or inadequate literacy in a health care environment. With the move towards a more "consumer-centric" health care system as part of an overall effort to improve the quality of health care and to reduce health care costs, individuals need to take an even more active role in health care related decisions. To accomplish this people need strong health information skills.

The Literacy Assistance Center of New York adds:
These are the skills that all people need to, for instance, find their way to the right place in a hospital, fill out medical and insurance forms, and communicate with healthcare providers.

The American Medical Association Ad Hoc Committee on Health Literacy defines health literacy as a constellation of skills, including the ability to perform basic reading and numerical tasks required to function in the health care environment.

The American Medical Association estimates that every year, $73 Billion is lost in unnecessary health care expenditures due to poor "health literacy," the inability of consumers and employees to obtain and understand health care education.

Zarcadoolas, Pleasant & Greer Advancing health literacy: A framework for understanding and action Jossey-Bass: 2006
The wide range of skills and competencies that people develop to seek out, comprehend, evaluate, communicate, and use health information and concepts to make informed choices, reduce health risks, reduce inequities in health, and increase quality of life.

From Center for Health Literacy at the University of Maryland School of Public Health. Health literacy is the ability to get information, understand it, and use information to lower risk and better health. 

Pfizer... the ability to read, understand, and act on health information

CommunicationHealth... a person’s ability to understand and use health information

McGraw-Hill Concise Dictionary of Modern Medicine...  A measure of a person's ability to understand health-related information and make informed decisions about that information; health literacy includes interpreting prescriptions and following self care instructions.

Health Literacy Consulting... a shared responsibility between patients (or anyone on the receiving end of health communication) and providers (or anyone on the giving end of health communication. Each must communicate in ways the other can understand."

Health literacy is the ability to get information, understand it, and use information to lower risk and better health.
University of Maryland Center for Health Literacy

In health promotion practice, health literacy means  to understand the conditions that determine health and to know how to change them. Source; Kickbush 2001

From the Center for Health Care Strategies, Inc., 1997.
The ability to read, understand and act on health-care information.

From the Joint Committee on National, Health Education Standards, 1998. The capacity of individuals to obtain, interpret and understand basic health information and services and the competence to use such information and services in ways which enhance health.

From Health Literacy as a Public Health Goal, Don Nutbeam, 2000.
The personal, cognitive and social skills which determine the ability of individuals to gain access, to understand and use information to promote and maintain good health.

Three levels of health literacy were identified:
1. basic or functional health literacy;
2. communicative or interactive health literacy;
and, 3. critical health literacy.

From Navigating Health: The Role of Health Literacy, Kickbusch, Wait and Maag, 2005. The ability to make sound health decisions in the context of everyday life—at home, in the community, at the workplace, in the healthcare system, the marketplace and the political arena. It is a critical empowerment strategy to increase peoples’ control over their health, their ability to seek out information and their ability to take responsibility.

International Views

In New Zealand health literacy has been defined as:
the degree to which individuals have the capacity to obtain, process and understand basic health information and services in order to make informed and appropriate health decisions.  (Kickbusch et al., 2005; Korero Marama, 2010)

Implicit in this definition is the need for the health system to not just present information in accessible ways, but also to engage with individuals to make sure they can access, understand and act on the information they receive.

When we use the term “health literacy” we are talking about more than using listening, speaking, reading, writing, and maths skills in a health setting, we are talking about the use of those skills and others such as analysis and decision making in order to navigate the health system, access and understand health information and make decisions on health.

Health literacy is a new concept that links our level of literacy with our ability to act upon health information and, ultimately, take control of our health. It builds upon the idea that both health and literacy are critical resources for everyday living.

Addressing health literacy means breaking down the barriers to health that low literacy creates and finding ways to enable all people to:

  • Access the services and supports they need
  • Understand and use information to promote their health and prevent disease
  • Make informed health decisions about self-care and treatment of illness
  • Advocate for their own health, as well as that of their family and community
  • Gain greater control over their health and well-being.

  • 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.

Health literacy describes the ability of an individual to make decisions and act in favour of their health in daily life - at home, in the community, at school, in the workplace, in the healthcare system, in the marketplace or in the political arena. Being health literate empowers people to increase control over their health, their ability to seek out health information, to navigate complex systems, to take responsibility and participate effectively in all aspects of life.

Definition of health literacy developed by the Canadian Expert Panel on Health Literacy: “Health literacy is the ability to access, understand, evaluate and communicate information as a way to promote, maintain and improve health in a variety of settings across the life-course."

Related Terms Defined

Medical Library Association defines Health Information Literacy as
...the set of abilities needed to: recognize a health information need; identify likely information sources and use them to retrieve relevant information; assess the quality of the information and its applicability to a specific situation; and analyze, understand, and use the information to make good health decisions.

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