California Family Health Council, Inc.

California Family Health Council (CFHC) has long promoted the importance of health literacy. We define health literacy as more than just "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”(1) We have long emphasized the importance that health care providers have in improving health communication with our clients. Health literacy is not only about an individual’s capacities, but also the health care provider’s ability to explain, write, and share health care information in a way that clients can truly understand and get the health care they need.

Research in the field of health literacy has grown dramatically in the last two decades. In 2003, the National Assessment of Adult Literacy (NAAL) assessed the English literacy of adults in the United States. For the first time, this survey included items specifically designed to measure the health literacy of American adults. This new component of the NAAL survey represents the first nationwide, comprehensive look at this issue.

Understanding health literacy is essential. Research shows that being able to successfully access health care and find needed health information is directly correlated with maintaining health and with positive health outcomes. Low health literacy is associated with poor communication between clients and health professionals and with poor health outcomes. In addition, low health literacy is also associated with:

• Increased hospitalization rates.
• Less frequent screening for life-threatening diseases such as cancer and diabetes.
• Disproportionately high rates of diseases and mortality even after adjusting for poverty, race, and low SES.

Health literacy is the single greatest predictor of overall health status.

The NAAL survey revealed that:

• About 36 percent of American adults had “Basic” or “Below Basic” skills in health literacy. These people lacked many of the skills typically needed to follow basic health instructions.
• Most American adults (53 percent) had “intermediate” health literacy. That means they could figure out a healthy weight range, tell by looking at a chart when children should get their vaccinations, and figure out when to take a medicine. But beyond that, some tasks often expected of clients might be difficult to perform.
• Only 12 percent of adults could be considered “proficient” in performing those skills typically needed to navigate the modern and complex health care system.

Levels of health literacy were shown to correlate with self-assessment of overall health. In general, the lower the health literacy skills exhibited by the individual, the more likely they were to report poor health. Forty-two (42) percent of those reporting poor health had below basic literacy skills, while only 8 percent of those reporting excellent health had below basic literacy skills.

Other findings of note included:

• Adults who received health insurance through an employer had higher average health literacy levels than adults who had no health insurance or state-funded insurance such as Medicare or Medicaid.
• Adults with below basic or basic health literacy were less likely to get information on health issues from written sources.
• Eighty (80) percent of adults with below basic health literacy skills got no information from the internet, while 85 percent of adults with proficient health literacy skills got at least a little information from the internet.

CFHC offers a variety of resources.

Health professionals can improve health literacy by ensuring that all health information and services can be understood and used by all. CFHC offers client education materials in multiple languages, all of which are written at or below the 5th grade reading level. Our trainings focus on teaching counselors, health workers, and providers how to teach their clients health information in a way they can understand. Click here to find more resources from CFHC that can help you improve the health literacy of your clients.

If you are interested in learning more about health literacy and would like to receive training on this topic, contact CFHC’s training division at trainings@cfhc.org.

List of Sources

1. U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2010. Retrieved 10/8/08 at http://www.health.gov/healthypeople/
2. The entire report, The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy can be downloaded at no charge.

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