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Examples of Literacy and Health Literacy

Health literacy and literacy are two closely associated terms. However, they differ in scope and meaning. For example, Healthy People 2020 (2011) defines health literacy as “The degree to which individuals could obtain, process and understand basic health information and services needed to make right health decisions” (p. 1). Comparatively literacy is “a general term that denotes a person’s ability to read, write, and understand English, as well as do basic computational skills to carry out a job” (Laureate Education, Inc., 2011, p. 1). Experts say health literacy skills are among the most reliable predictors of health outcomes (Zoellner et al., 2011). In fact, researchers say they rank above, income, social class, age, employment status and other socioeconomic determinants of health (in predicting health outcomes) (National Network of Libraries of Medicine, 2015). Health experts measure health literacy skills on four levels – “below basic,” “basic,” “intermediate,” and “proficient.” According to the National Network of Libraries of Medicine (2015), 35% of all adults in America have limited health literacy skills. It also says 22% of the same demographic have the basic health literacy skills and 14% have less than basic health literacy skills (National Network of Libraries of Medicine, 2015).

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Based on the above statistics, nonprofessionals do not usually have advanced health literacy skills. For example, understanding the biological processes that cause diabetes requires advanced health literacy skills because ordinary people would not understand the roles of beta cells and insulin in diabetes management (Laureate Education, Inc., 2011). Therefore, having basic health literacy skills would help to understand such issues. Comparatively, someone who knows how to read, write, speak English, or solve a simple mathematical equation could be termed literate, but not health literate. Broadly, literacy is a general term for conveying people’s comprehension of general issues, but health literacy is a more specific term of explaining people’s comprehension of health matters.

Health-Related Consequences of Low Health Literacy

Health literacy has been a priority area for advancing public health goals. The US government recognizes its importance in promoting socioeconomic equity because the consequences of low health literacy are undesirable (National Network of Libraries of Medicine, 2015). Health researchers have affirmed a direct correlation between unhealthy lifestyle habits and low health literacy levels (Jibaja-Weiss et al., 2011). For example, Zoellner et al. (2011) say the relationship between low health literacy and poor dietary choices stem from low health literacy levels in America. The researchers proposed this finding after investigating how health literacy skills affected people’s access to nutritious foods, their comprehension of nutritious foods, and their propensity to adopt healthy dietary behaviors (Zoellner et al., 2011).

Low levels of health literacy could also lead to poor treatment choices, especially for people who suffer from terminal illnesses. For example, Jibaja-Weiss et al. (2011) say low literacy levels have often led medically underserved people in the society (people from low socioeconomic levels, people who lack private health insurance and the elderly) to make poor treatment choices for managing breast cancer. In the same study, the researchers showed that the lack of health literacy skills led to a later stage diagnosis of breast cancer, which reduced the treatment options for those affected by the cancer (Jibaja-Weiss et al., 2011). The researchers conducted this study after investigating the effects of low health literacy levels on women’s choice to select breast-conserving surgery (BCS) and mastectomy (MT) as alternative treatment options for breast cancer. The Agency for Healthcare Research and Quality corroborates the above findings by affirming a direct correlation between low literacy levels and higher risks of death (National Network of Libraries of Medicine, 2015). It also extends the same relationship to high numbers of emergency room visits.

Populations at Risk of Poor Health because of Low Health Literacy levels


The National Assessment of Adult Literacy (cited in the National Network of Libraries of Medicine, 2015) reports that low health literacy levels were common among non-English speaking American citizens. Most immigrants fall within this demographic. To explain this fact, Laureate Education, Inc. (2011) says immigrants are at risk of poor health (based on low health literacy levels) because they may have adopted a culture that differs from American health practices. For example, spiritual factors may affect their perceptions of health issues. Based on this fact, some immigrants could say a poor spiritual state causes a poor health status (Laureate Education, Inc., 2011).

Senior Citizens

Although senior citizens suffer the highest risk of developing chronic illnesses, they often have low health literacy levels. Based on this fact, the National Network of Libraries of Medicine (2015) says 71% of adults aged above 60 years have trouble comprehending health information written in hard copies. Similarly, 80% of this demographic have trouble comprehending health data from statistical tools, such as graphs and pie charts (National Network of Libraries of Medicine, 2015). Their low comprehension skills stem from their poor health standards. This is why they have low health literacy levels. However, besides senior citizens and immigrants, other vulnerable populations include medically underserved populations that may have their health outcomes limited by lower socioeconomic statuses, low educational levels, and the lack of private health insurance.


Healthy People 2020. (2011). Health Literacy Interventions and Outcomes: An Updated Systematic Review. Web.

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Jibaja-Weiss, M., Volk, R., Granchi, T., Neff, N., Robinson, E., Spann, S.,…Beck, R. (2011). Entertainment education for breast cancer surgery decisions: A randomized trial among patients with low health literacy. Patient Education and Counseling, 84(1), 41-48.

Laureate Education, Inc. (Executive Producer). (2011). Health Literacy. Baltimore, MD: Author.

National Network of Libraries of Medicine. (2015). Health Literacy. Web.

Zoellner, J., You, W., Connell, C., Smith-Ray, R., Allen, K., Tucker, K.,…Estabrooks, P. (2011). Health literacy is associated with health eating index scores and sugar-sweetened beverage intake: Findings from the rural lower Mississippi delta. Journal of the American Dietetic Association, 111(7), 1012-1020.

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