Network for Information and Digital Access

Health Literacy (HL)

There are multiple definitions of health literacy, such as:

  • the ability to obtain, read, understand and use healthcare information to make appropriate health decisions and follow instructions for treatment;
  • the degree to which people are able to access, understand, appraise and communicate information to engage with the demands of different health contexts in order to promote and maintain good health across the life-course;

A more developed perspective defines health literacy as the wide range of skills, and competencies that people develop over their lifetimes to seek out, comprehend, evaluate, and use health information to make informed choices, reduce health risks, and increase quality of life. It includes the ability to understand scientific concepts, content, and health research; skills in spoken, written, and online communication; critical interpretation of mass media messages; navigating complex systems of health care and governance; and knowledge and use of community capital and resources, as well as using cultural and indigenous knowledge in health decision making. Health literacy is seen as a social determinant of health that offers a powerful opportunity to reduce inequities in health. 

To function well in the 21st century a person must possess a wide range of abilities and competencies, in essence many ‘literacies’. These ‘literacies’—from being able to read a newspaper to understanding information provided by a health care provider—are multiple, dynamic, and malleable. Health literacy is an emerging concept that involves the bringing together of people from both the health and literacy fields, building on the idea that both health and literacy are critical resources for everyday living. Our level of literacy directly affects our ability to not only act on health information but also to take more control of our health as individuals, families and communities. 

Specific types of health literacy include maternal health literacy, defined as the cognitive and social skills that determine the motivation and ability of women to gain access to, understand, and use information in ways that promote and maintain their health and that of their children. In the related field of birth and reproductive health, in Africa there is evidence that women (and some men) are keen to understand more about their bodies and what's happening.  Knowledge varies between some women knowing nothing at all about eating well, menstrual cycles, contraception and pregnancy to others having a good understanding of how drinking more water might make them feel stronger and how they get pregnant. Illiteracy is widespread so that images are important in communicating knowledge. Engaging local birth attendants who are known and respected in the community is often most effective.

Lancet editor-in-chief Richard Horton has recently argued for a holistic ‘planetary health’ as an approach, specifically linking health with other sustainability issues relevant to the whole of society such as education, adolescence, gender, justice, environment, human-caused changes to climate and other dimensions, speaking of a ‘vision … for a planet that nourishes and sustains the diversity of life with which we coexist and on which we depend….the health of human civilization and the state of the natural systems on which it depends…. connect humanity’s environmental impact on the planet with the survival of human civilization itself. being stewards for all the things that surround us’.  

Society as a whole is responsible for improving health literacy, but most importantly the healthcare, public health professionals and public health systems. Where there are adequate levels of health literacy, that is where the population has sufficient knowledge and skills and where members of a community have the confidence to guide their own health, people are able to stay healthy, recover from illness and live with disease or disability.

Health literacy is important in addressing health inequities, since those at lower levels of health literacy are often the ones who live in poorer socio-economic communities. Not being aware of information relevant to improving their health, or how to access health resources creates higher levels of disadvantage. For some people, a lack of education and health literacy that would flow from education prevents empowerment at any time in their lives.

Weak health literacy skills are associated with riskier behaviour, poorer health, less self-management and more hospitalization and costs. Strengthening health literacy has been shown to build individual and community resilience, help address health inequities and improve health and well-being.

eHealth literacy is a term that describes the relatively modern concept of an individual's ability to search for, successfully access, comprehend, and appraise desired health information from electronic sources and to then use such information to attempt to address a particular health problem.

A combination of several different Health literacy skills is required in order to facilitate eHealth promotion and care including:

  • Traditional literacy
  • Media literacy
  • Information literacy
  • Computer literacy
  • Scientific literacy
  • Health literacy

The scope of health literacy has three distinct ‘levels’: 

Functional literacy: skills that allow an individual, for example, to read consent forms, medicine labels, and health care information and to understand written and oral information given by physicians, nurses, pharmacists, or other health care professionals and to act on directions by taking medication correctly, adhering to self-care at home, and keeping appointment schedules. 

Conceptual literacy: the wide range of skills, and competencies that people develop over their lifetimes to seek out, comprehend, evaluate, and use health information and concepts to make informed choices, reduce health risks, and increase quality of life. 

Health literacy as empowerment: strengthening active citizenship for health by bringing together a commitment to citizenship with health promotion and prevention efforts and involving individuals in: understanding their rights as patients and their ability to navigate through the health care system; acting as an informed consumers about the health risks of products and services and about options in health care providers, and acting individually or collectively to improve health through the political system through voting, advocacy or membership of social movements. 

Health literacy is important for population health because it can beneficially impact: health outcomes, rates of chronic disease, health care costs, health information demands; and health inequalities.

We welcome comments on the draft definitions of terms for Health Literacy with a view to their improvement and to come to a common understanding. Please complete this form.