Health literacy allows the public and personnel working in all health-related contexts to find, understand, evaluate, communicate, and use information to make informed decisions. Health literacy has always been present, but it is only during the past two decades that research and practice have begun to formalize the idea and increase effectiveness of research and practice.
While the origins of the field of health literacy are truly international, growth of the field in the United States was propelled by the findings of the National Adult Literacy Survey (NALS) in 1993 and the National Assessment of Adult Literacy (NAAL) in 2003. Although the 1993 NALS did not include a measure of health literacy, the findings did impact perceptions of the literacy skills present, and lacking, in American adults. The survey generated substantial interest into the implications of low literacy. The 2003 NAAL included a measure of health literacy, and those results have further generated interest in the connections between literacy and health in the United States.
The NAAL reported that 88 percent of Americans (nearly 9 out of 10) are below the proficient level in health literacy. Hundreds of studies indicate that the proficient level in health literacy is where Americans need to be in order to successfully navigate the complex health system in this country.
Defining Health Literacy
Health literacy has been variously defined by different people and organizations. Early approaches focused on health literacy as a way for health professionals to get patients to do what they wanted. Those definitions focused on "appropriate decisions" as outcomes of addressing health literacy.¹ Early conceptions of health literacy also focused on the concept as something that only patients or the public lacked, assuming that health professionals were fully equipped with health literacy skills.
One hallmark in that history was the 2006 Surgeon General's Workshop on Improving Health Literacy, initiated by Canyon Ranch Institute President Richard H. Carmona M.D., M.P.H., FACS, while he served as 17th U.S. Surgeon General (2002-2006). The Surgeon General's Workshop on Improving Health Literacy was among the first meetings at the national level to recognize the importance of health literacy and provide a venue for people who are working to advance health literacy to start to forge a new consensus on health literacy.
Today, there is strong movement toward defining and practicing health literacy as a theory of health behavior change, not just a set of skills that some people may or may not have. For example, the Calgary Charter on Health Literacy defines health literacy as that which allows the public and personnel working in all health-related contexts to find, understand, evaluate, communicate, and use information to make informed decisions.
This definition inherently contains a logic model that all people, programs, and institutions can follow as they try to make, or help people make, informed decisions about health. That logic model begins with finding information – then moves through understanding, evaluating, and communicating – and concludes with using information (i.e. behavior change).
Health Literate Partnerships and Programs
Canyon Ranch Institute weaves a robust approach to health literacy into all our integrative health programs to improve the health of individuals and populations and into our approaches to health system reform. Our goal is to help individuals, communities, and nations make informed decisions about health and increase the health and well-being of all people.