FIGURE D-1 Life course perspective on health literacy.
SOURCE: Sanders, L.M., adapted from Halfon, N., Hochstein, M. Milbank Quarterly 2002; 80(3):433.

medical home (embracing needed medical, dental, nutritional, and psychosocial support services). During the school-age years and adolescence, the educational system provides Zoe an effective curriculum that integrates developmentally appropriate health-behavior content within her reading, math and science curricula, and the health system continues to provide access to the family-centered medical home. As a health-literate adult, Zoe effectively accesses and uses written and electronic health information, and she serves as an effective advocate for her own health, for her children’s health, and for her grandchildren’s health.

At the population-health and public-policy level, this life-course perspective suggests that improving the nation’s health will require coordinated investments from educational and health systems to support the health literacy skills of individuals as they mature from newborn citizens to senior citizens.


In response to the Affordable Care Act, the Institute of Medicine’s Health Literacy Roundtable could best improve the ACA’s attention to this life-course perspective on child health by focusing discussions on community-based funding, advocacy, and research on the following priorities:

  1. To Extend Coverage to All Children: Simplify the CHIP and Medicaid Enrollment Process.

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