Health and Literacy: A Review of Medical and Public Health Literature

Literacy has recently emerged as a key item on the research agenda in medicine and public health. Researchers and practitioners are grappling with evidence that the reading ability of the average adult falls well below the reading level of educational materials, directives, forms, and informed-consent documents commonly used in the health field. The threats to effective communication and efficacious care have spurred interest in exploring strategies for more effective communication. In addition, increased attention to literacy may be driven by legal concerns for adequate protection of human subjects and ethical concerns for patient autonomy in informed-consent procedures. Methodological strides made since 1992, particularly in the form of new tools for rapid literacy measurement, have enabled a number of researchers to explore links between the literacy level of patients and health outcomes that will have critical policy implications. These investigations can best be undertaken through collaborative efforts between educators who understand the learning process and health professionals who understand the protocols used in health care and public health education. Findings will serve to enrich policy and practice.