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Health literacy is the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment. There are multiple definitions of health literacy, in part, because health literacy involves both the context (or setting) in which health literacy demands are made (e.g., health care, media, internet or fitness facility) and the skills that people bring to that situation.

Since health literacy is a primary contributing factor to health disparities, it is a continued and increasing concern for health professionals. The 2003 National Assessment of Adult Literacy (NAAL) conducted by the US Department of Education found that 36% of participants scored as either "basic" or "below basic" in terms of their health literacy and concluded that approximately 80 million Americans have limited health literacy. These individuals have difficulty with common health tasks including reading the label of a prescribed drug,. Several factors may influence health literacy. However, the following factors have been shown to strongly increase this risk: identify as a racial or ethnic minority, age (especially patients 65 years and older), limited English language proficiency or English as a second language, less education, and lower socioeconomic status. Patients with low health literacy understand less about their medical conditions and treatments and overall report worse health status.

Various interventions, such as simplifying information and illustrations, avoiding jargon, using "teach-back" methods, and encouraging patients' questions, have improved health behaviors in persons with low health literacy. The proportion of adults aged 18 and over in the U.S., in the year 2010, who reported that their health care providers always explained things so they could understand them was about 60.6%. This number increased 1% from 2007 to 2010. The Healthy People 2020 initiative of the United States Department of Health and Human Services (HHS) has included health literacy as a pressing new topic, with objectives for improving it in the decade to come.

In planning for Healthy People 2030 (the fifth edition of Healthy People), HHS  issued a "Solicitation for Written Comments on an Updated Health Literacy Definition for Healthy People." Several proposals address the fact that "health literacy is multidimensional", being the result of a concerted effort that involves the individual seeking care or information, providers and caregivers, the complexity and demands of the system, and the use of plain language for communication.

Factors that contribute to health literacy
A study of 2,600 patients conducted in 1995 by two US hospitals found that between 26% and 60% of patients could not understand medication directions, a standard informed consent form, or materials about scheduling an appointment. The 2003 National Assessment of Adult Literacy (NAAL) conducted by the US Department of Education found that 36% of participants scored as either "basic" or "below basic" in terms of their health literacy and concluded that approximately 80 million Americans have limited health literacy.

Many factors contribute to the health literacy of an individual. Racial and ethnic minorities, and immigrant and displaced individuals are at increased risk for low health literacy. Limited health literacy is more common in Black (58%), Hispanic (66%), and American and Alaskan Natives (48%). Immigrant and displaced populations populations are vulnerable to low health literacy due to significant language, cultural, and economic barriers to relevant health information. Language is a large roadblock to health literacy, with the NAAL identifying approximately 4 million adults who could not complete the NAAL health literacy survey due to language barriers.

Socioeconomic status is closely linked to health literacy and health outcomes. Individuals with incomes at or below the poverty level are at risk for low health literacy. Low health literacy is also higher in groups with less education.

Another factor that contributes to low health literacy includes the over estimation of patients' health literacy skills by physicians and health care providers. Physicians often incorrectly assume the patient has understood medical instructions or diagnosis. However, because there is little evidence that trying to determine a patient's health literacy skills in clinical practice settings improves patient health outcomes, it is not recommended as a part of routine clinical care. The growing complexity of the of the health care system, including navigating multiple health care providers, pharmacies, medications, and insurance, also complicates health literacy for many individuals.

It is important to note that the health literacy of an individual can vary and change over time based on their emotional state, acute pain or illness, vision and hearing deficits and cognitive impairment. Age and chronic illness are also contributors to low health literacy. Health literacy is limited amongst those 65 and older ; and adolescents and young adults may be more vulnerable to underdeveloped health literacy skills relative to older adults. Those with chronic illnesses must regularly engage multiple health literacy tasks including those that involve communication of relevant information with their providers, understanding providers information, and independently figuring out appropriate medicine dosages, that may be difficult to navigate.

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Many factors determine the literacy levels of health education materials or interventions: readability of the text, the patient's current state of health, language barriers between the clinician and patient, cultural appropriateness of the materials, format and style, sentence structure, use of illustrations, and numerous other factors.

Results of a systematic review of the literature found that when limited English proficient (LEP) patients receive care from physicians who are fluent in the patients' preferred language, referred to as having language concordance, generally improves outcomes. These outcomes are consistent across patient-reported measures, such as patient satisfaction, and also more such as blood pressure for patients with diabetes.

Standardized measures of health literacy are the Newest Vital Sign (NVS), which asks people about a nutrition label, and the Test of Functional Health Literacy (TOFHLA), which asks test-takers to fill in 36 blanks in patient instructions for X-rays and a Medicaid application, from multiple choices, and 4 numbers in medicine dosage forms.

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