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1 Introduction Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. Nearly half of all American adults—90 million people—have inadequate health literacy to navigate the health - care system (IOM, 2004). The Institute of Medicine (IOM) convened the Roundtable on Health Literacy to address issues raised in the report, Health Literacy: A Prescrip- tion to End Confusion (IOM, 2004). The roundtable brings together leaders from the federal government, foundations, health plans, associations, and private companies to discuss challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors. The roundtable also serves to educate the public, press, and policy makers regarding issues related to health literacy. The roundtable sponsors workshops for members and the public to dis - cuss approaches to resolve key challenges. An area of interest for the roundtable is ways in which various organi- zations and individuals within a state can work to improve health literacy within that state. As a result, the roundtable cosponsored a workshop with the University of California, Los Angeles (UCLA), Anderson School of Management in Los Angeles on November 30, 2010. The workshop focused on understanding what works to improve health literacy across a state, including how various stakeholders have a role in improving health literacy. The focus of the workshop was on presentations and discus- sions that address (1) the clinical impacts of health literacy improvement 1

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2 IMPROVING HEALTH LITERACY WITHIN A STATE approaches; (2) economic outcomes of health literacy implementation; and (3) how various stakeholders can affect health literacy. The workshop was organized by an independent planning commit- tee in accordance with the procedures of the National Academy of Sci- ences. The planning group included Sharon Barrett, Darren DeWalt, Jean Krause, Ruth Parker, Dean Schillinger, and Carol Teutsch. The role of the workshop planning committee was limited to planning the workshop. Planning committee members developed the agenda topics, and selected and invited expert speakers and discussants to address identified topics. Unlike a consensus committee report, a workshop summary may not contain conclusions and recommendations. Therefore, this summary has been prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. All views presented in the report are those of workshop participants. The report does not contain any findings or rec - ommendations by the planning committee or the roundtable. The workshop was moderated by roundtable chair, George Isham, and featured presentations and discussion. Chapter 2 presents a sum- mary of the keynote address on the role of the university in improving health literacy. Chapter 3 focuses on state-based models to improve health literacy. In Chapter 4, the role of the university in improving health lit- eracy statewide is explored further. Chapter 5 covers improving health literacy at the community level. Chapter 6 follows with a general discus - sion of the day’s proceedings.