Health literacy is the degree to which individuals can obtain, process, and understand basic health information and services needed to make appropriate health decisions. Low health literacy affects nearly 9 out of 10 adults in the United States, making it difficult to follow medical instructions, navigate the healthcare system, or manage chronic conditions. This limited ability is associated with increased hospitalizations, greater use of emergency services, and higher healthcare costs. Improving health literacy enhances public health outcomes, increases patient safety, and works toward health equity.
Training Healthcare Providers for Clear Communication
Improving communication skills among healthcare professionals directly addresses the organizational responsibility in health literacy. Providers can use behavioral techniques to ensure patients fully grasp their diagnosis, treatment plan, and self-care instructions. A method proven to increase patient understanding is the “teach-back” technique, where the provider asks the patient to explain, in their own words, what they need to know or do.
The teach-back method is not a test of the patient’s intelligence, but rather a way for the provider to confirm they have explained the information clearly. If the patient’s explanation is incorrect or incomplete, the provider must rephrase the information using different words and check for understanding again. This cycle repeats until the provider is confident the patient has fully understood the key messages.
Effective communication also requires the consistent use of plain language, which involves avoiding medical jargon and technical terms. For example, a provider should use “pill” instead of “medication” or “eat” instead of “consume.” When discussing complex care plans, providers should limit the amount of new information presented in a single visit, often referred to as the “rule of three.”
Practitioners enhance clarity by segmenting and checking information in small “chunks” throughout the visit, instead of waiting until the end to summarize. Encouraging open-ended questions, such as “What questions do you have about this treatment?” rather than “Do you understand?” fosters active participation. Incorporating visual aids like diagrams, models, or pictures reinforces verbal explanations and accommodates different learning styles.
Designing Accessible Health Materials and Environments
Systemic improvements to health information delivery and the physical environment support personal health literacy. Health organizations must adjust their materials and settings to meet user needs, rather than placing the burden of comprehension solely on the patient. This organizational health literacy requires ensuring that all written materials, such as patient portals, discharge instructions, and consent forms, adhere to low-literacy design principles.
Written materials should aim for approximately a sixth-grade reading level, ensuring accessibility for about 75 percent of the adult population. This is achieved by using short, common words and constructing simple, specific sentences no longer than about 10 words, written in the active voice. Information should be “chunked” into small, digestible segments, as readers with low literacy may struggle to process more than five pieces of information at once.
Visual design plays a significant role in accessibility, particularly for individuals with low vision or cognitive challenges. Print materials benefit from using a large font size, such as 18-point type for body copy, and ensuring strong contrast, like black text on a white background. Using clear, descriptive headings and leaving the right margin ragged, rather than justified, makes the text easier to scan and read.
Beyond written content, the physical setting of care facilities must also be navigable. Clear, standardized signage using simple words and universally understood symbols helps patients and visitors find their way without confusion. For digital health information, accessibility standards must be applied, including making content compatible with screen readers and presenting information in a logical, prioritized order.
Expanding Health Literacy Through Community Education
Improving health literacy outside of the clinical encounter involves proactive public health strategies that build foundational knowledge and critical evaluation skills. This approach focuses on empowering individuals before a health crisis, ensuring they can access, appraise, and apply information to maintain their well-being. Community education programs leverage existing social structures to deliver health information in familiar, low-stress settings.
Schools are a powerful location for integrating health literacy education, providing students with skills to make informed decisions about nutrition, physical activity, and preventive care. Initiatives can focus on building health self-efficacy—the confidence to manage one’s own health—through curriculum-based programs and partnerships with school-based health centers. These efforts target future generations and can also engage parents and family members.
Community-based organizations, such as libraries and senior centers, serve as accessible hubs for health literacy resources and workshops. Libraries can host seminars on topics like understanding prescription labels, navigating health insurance, and identifying reliable online health sources. This outreach is effective for reaching vulnerable populations, including older adults, who benefit from tailored programs on chronic disease management and medication adherence.
A further strategy involves training community members to become “Trusted Messengers” who can disseminate evidence-based health information to their peers. This peer-to-peer approach enhances communication by utilizing language and cultural expressions familiar to the local population. By partnering with non-traditional organizations like local government and community groups, health literacy efforts can be sustained and integrated into daily life.