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Health Literacy Resources Refresher

Friday, February 13, 2015   (0 Comments)
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by Emily J. Glenn, MLIS, AHIP, Community Health Outreach Coordinator, National Network of Libraries of Medicine, Pacific Northwest Region


Adequate health literacy is essential to health care, public health, and the way our society views health. Improving the health literacy of the population has been broadly recognized as an important goal and is one of the major objectives in the Healthy People 2020 Health Communication and Health Information Technology topic.   Health literacy is not just about reading --- it requires a complex group of reading, listening, analytical, and decision-making skills, and the ability to apply these skills to health situations. For example, it 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.


Consumers rely heavily on the health information that is available to them, yet about 9 out of 10 American adults have some problems with health literacy. The National Assessment of Adult Literacy (NAAL) report—The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy—provides first-hand information on the status of the health literacy of American adults age 16 and older and shows that socioeconomic factors are linked to health literacy. 


NAAL reports that low health literacy is higher among adults who spoke a language other than English before starting school and among individuals who did not complete high school. More than 76% of respondents in the survey who did not complete high school scored at the "Below Basic" or "Basic" level of health literacy.  NAAL also reported a relationship between health literacy and race or ethnicity. White respondents scored better on the survey than other ethnic or racial groups. Only 9% of White respondents scored at the lowest (“Below Basic”) level. However, 24% of Blacks, 41% of Hispanics, 13% of Asians, and 25% of American Indian and Native Alaskan respondents scored at the "Below Basic" level. Based on the NAAL research, adults living below the poverty level have lower average health literacy than adults living above the poverty threshold. In adults who receive Medicaid, 30% have "Below Basic" health literacy. People with chronic mental and/or physical health conditions are also at risk for low health literacy.


People with low health literacy use more health care services, have a greater risk for hospitalization, and have a higher utilization of expensive services, such as emergency care and inpatient admissions.


Health literacy--especially when combined with a focus on prevention and integrative health--is one of the most promising approaches to advancing public health[1]. Below is a selection of relevant and freely available resources for practitioners, educators, and others who are in a position to manage communications and outreach or develop programs to improve literacy. 


The AHRQ Health Literacy Universal Precautions Toolkit, 2nd edition, can help primary care practices reduce the complexity of health care, increase patient understanding of health information, and enhance support for patients of all health literacy levels. Presentations include a “shadow” visit to a doctor’s office and a presentation packed with practical strategies that can help practices do a better job caring for people with low health literacy.


Understanding Medical Words: A Tutorial from the National Library of Medicine is a game-like interactive tutorial that teaches how to put together parts of medical words and provides basic patient-provider scenarios for learning. The tutorial can also be downloaded.


Promoting Health Literacy with Free Information & Cool Tools from your National Library of Medicine is a three-part video training series (facilitator guide included) designed for social and health services providers and programs with limited time and money for training and materials. The brief videos (8-10 minutes) focus on evidence-based information resources and empowering patients and families to use them, developing reflective health literacy skills needed to use information for health, and empower a person to use information for health. This includes a role-played health story.


The CDC offers five online health literacy courses for health professionals covering writing, speaking, communicating visually, explaining risk and using numbers. Good Questions for Good Health toolkit, a consumer and patient communication skill-building module, encourages question-asking and provides strategies for formulating and asking questions before, during, and after medical appointments. The Toolkit includes a presentation, presentation notes, skill building activity, take-home handout, and an evaluation form.


NWRPCA also provides guides to several resources on its Health Literacy page.



Emily J. Glenn, MLIS, AHIP

Community Health Outreach Coordinator

National Network of Libraries of Medicine, Pacific Northwest Region

University of Washington Health Sciences Library

Box 357155, Seattle, WA 98195

Phone: (206) 616-7283     Fax:  (206) 543-2469




[1] Pleasant, A. (2014). Advancing Health Literacy Measurement: A Pathway to Better Health and Health System Performance. Journal of Health Communication, 19(12), 1481–1496. doi:10.1080/10810730.2014.954083


NWRPCA welcomes and regularly publishes white papers and articles submitted by members, partners and associates with subject matter expertise. The appearance of any guest publication in our Health Center News database represents the views of the author and does not constitute endorsement by NWRPCA of the stated opinions or perspectives, nor does it suggest endorsement of the contributor's products or services.


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