Over the past two decades, research has examined the issue of low literacy and its impact on health. Of the more than 1,600 articles in the health literacy research literature, about half address the issue of written health information that is too complex for understanding by the average adult American who reads at an eighth-grade level. The other 800 articles focus on the link between poor literacy, poor reading skills, or poor health literacy and various health outcomes such as increased mortality.

In exploring the link between literacy and mortality, Baker and colleagues (2007) found that a clear correlation exists between inadequate health literacy and increased mortality rates (see Figure 3-1). In fact, the study showed that there is a 50 to 80 percent increased mortality risk for people with inadequate health literacy. Importantly, the study also found that poor health literacy is a stronger indicator of mortality risk than overall years of schooling.

Data from the National Health Literacy Survey of 1992 and the 2005 National Assessment of Adult Literacy show that African Americans and Hispanics are overrepresented in the lowest levels of literacy proficiency (Kutner et al., 2006). This also parallels the

FIGURE 3-1 Those with inadequate health literacy had higher mortality rates than those with adequate or marginal health literacy. Literacy and mortality risk are of the study population (n = 3260 Medicare managed care enrollees). Literacy is assessed by a shortened version of the Test of Functional Health Literacy in Adults. Results are adjusted for age differences.

FIGURE 3-1 Those with inadequate health literacy had higher mortality rates than those with adequate or marginal health literacy. Literacy and mortality risk are of the study population (n = 3260 Medicare managed care enrollees). Literacy is assessed by a shortened version of the Test of Functional Health Literacy in Adults. Results are adjusted for age differences.

SOURCE: Baker et al., 2007. Copyright © (2007) American Medical Association. All rights reserved.



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