Health Literacy

 Definition: The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (IoM, 2004).

People with Low Health Literacy (Schwartzberg, et al. 2004)—

  • Use screening/preventive services less
  • Present for care with later stages of disease
  • Are more likely to be hospitalized
  • Have poorer understanding of treatment and their own health
  • Adhere less to medical regimens
  • Have increased health care costs
  • Die earlier


While there is a wide range of health literacy in the general U.S. population, over half of elders from Mexican backgrounds and over 30% from all the Asian subpopulations except Japanese and Filipinos have less than a ninth grade education, (many times in schools in their countries of origin) which puts them at special risk for low health literacy in the U.S. health care system.

Suggestions for communicating with elders with low health literacy (Hikoyeda, 2008)

  • Entire staff must be involved in lowering health literacy barriers
  • Be supportive and sensitive
  • Speak to and treat an individual, not “another patient”
  • Speak slowly and start with context
  • Use a quiet room with minimal distractions
  • Use everyday language
  • Avoid technical terms
  • Be concrete and use the active voice
  • Start with the most important information first and limit new information
  • Give no more than one or two instructions at a time – and check on each as you go, using the “teach back” method (having the patient repeat the information)
  • Be creative (e.g., tape pills to card; color code medications; or draw a sun to indicate taking them in the morning)
  • Phone reminders can make a real difference