Health Literacy: A Second Decade of Distinction for Americans (original) (raw)

2010, Journal of Health Communication

Efforts to describe health literacy in the last decade have helped us define the issue and recognize that our public's skills and abilities are not adequate for successfully navigating the growing demands and complexity of healthcare. There have been significant developments in health literacy over the last decade, with milestones of progress. Much of the work done in the 1990s focused on defining health literacy, initially measuring its prevalence and subsequently looking at its associations. Since then, health literacy has grown from an issue of an under-recognized ''silent epidemic'' to an issue of health policy and reform. Ideas and objectives proposed have actually been adopted in recent years, with significant policy developments. This article recognizes many achievements and milestones while developing recommendations for implementation in the decade ahead. Over a decade ago, we worked with the National Library of Medicine to document the evidence-base for health literacy with the goal of providing Americans with ''the currency patients need to negotiate a complex health care system'' (Ratzan & Parker, 2000) At that time, we defined health literacy as the ''degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.'' The Department of Health and Human Services' in Healthy People 2010, the Institute of Medicine, and federal legislation later adopted this definition and have used it for advancing a health literate America. Much of the work done in the 1990s was focused on defining health literacy, initially measuring its prevalence, and subsequently looking at its associations. This work was summarized in the 2004 IOM report Health Literacy: A Prescription to End Confusion which concluded that ''efforts to improve quality, reduce costs, and reduce disparities cannot succeed without simultaneous improvements in health literacy'' (IOM, 2004). In 2004, the AHRQ released an evidence-based review of literacy and health outcomes, concluding that low literacy is associated with several adverse health