Health Literacy: Views from the Field
By Sandra Smith, MPH, CHES

A review of the National Institute for Literacy-Health email discussion list
(NIFL-H) 2000 archives reveals at least three lively exchanges on the
definition of health literacy. In these discussions, three points of view
emerge. Of course, the viewpoints are related and overlap and individuals
sometimes shift their view. No ranking is intended by the labeling of these
views or the order of presentation.

The Health and Literacy View
From this view, advocates see health literacy as a literacy problem.
Advocates are from the literacy community and seek to incorporate a health
focus into their classes and services; or they are from the healthcare
community and seek to increase understanding of healthcare information
through increased general literacy. This shared viewpoint makes sense since
the populations served by the literacy community also are heavy users of the
healthcare system.

In this view, low health literacy reflects a larger failure of the education
system. The concern is that low general literacy reduces understanding of
healthcare information to a degree that jeopardizes quality of care and
patient safety.


The functional health literacy view
Advocates taking this view frame health literacy as the ability to function
adequately in a healthcare environment. This view expands health literacy to
include medical decision making, risk evaluation, and effective information
exchange with professionals. The concern from this point of view is that low
functional health literacy interferes with history taking and diagnosis,
leads to medication errors, extended lengths of stay, and rehospitalization.
Low functional health literacy is seen as a major financial drain on the
healthcare system. Advocates approach health literacy as a disease for which
medical professionals should screen in order to treat ‘sufferers’
differently from others.

Health literacy as health-specific knowledge
From this viewpoint, advocates focus on the content and delivery of
information and how to convey complex health, healthcare, and medical
information in ways that the majority of the population can readily
understand. The concern from this point of view is that almost everyone
outside the health professions has low health literacy - that is, they do
not have the working knowledge of health and healthcare to enjoy full access
to services. They lack the medical vocabulary to articulate problems or
apply instructions as medical professionals expect. Low health literacy is
viewed not a disease or a failing of the education system, but rather as the
normal condition among patients/consumers, which is exacerbated by lack of
communication skills among healthcare professionals.

Reference
National Institute for Literacy Health & Literacy Online Discussion List,
Archives, 2000
http://www.nifl.gov/lincs/discussions/nifl-health/health_literacy.html

-----Original Message-----
From: Health Promotion on the Internet [mailto:[log in to unmask]]On
Behalf Of Annie Villeseche
Sent: Tuesday, November 20, 2001 4:06 PM
To: [log in to unmask]
Subject: Health literacy


Hello
I am looking for a definition of health literacy. Thank you for your help.
Annie
--------------------------

Annie Villesèche
Workforce Development Coordinator
Health Promotion
Social and Emotional Wellness Branch
(SOEWELL)
Department of Health and Community Services
Darwin NT
PO Box 40596 Casuarina NT 0811 Australia

Ph 08 8999 2615
Fax 08 8999 2420
Email [log in to unmask]