After leaving the position of Surgeon General, Dr. Carmona took the ideas and concepts he had been working with to the Canyon Ranch Institute, a nonprofit organization whose mission is to help educate, inspire and empower every person to prevent disease and embrace wellness. The Canyon Ranch Institute views health literacy as


  • a tool for prevention and better care;
  • important for clinical, public health, K-12 education, adult literacy, care advocacy and navigation, and workplace wellness and workforce productivity;
  • including the skills and abilities that determine the extent that all people can find, understand, evaluate, communicate, and use health information; and
  • leading to informed choices, reduced health risks, better navigation of the existing health care system, reduced inequities in health, and increased quality of life.


Health literacy is not about communicating health for health’s sake, Cabe said, but rather about communicating health in the context of what people need to know. This applies to individuals, parents, educators, health care professionals, health care systems, policy makers and policy brokers, government staff and officials, media, and community leaders.

In the ongoing debate about health care reform there is an opportunity to make prevention as great a priority as treatment, and to recognize the contributions of health literacy to both. Investment in the avoidable causes of mortality, that is in prevention efforts, are dwarfed by our investment in medical care and biomedical research. Health care reform, Cabe said, is an opportunity to focus the system on prevention rather than sick care.

Chronic diseases account for more than 75 cents of every dollar spent on health care in the United States. Yet most chronic diseases are preventable or manageable with appropriate preventive efforts. If one were the chief executive officer of a company and realized that 75 percent of company spending was unnecessary, it would be time to determine how to stop the waste. Prevention can eliminate unnecessary spending as well as save lives and reduce and eliminate suffering from many diseases that are completely preventable, Cabe said. Health literacy can lead the way, she said, and she proposed some strategies:


  • Communicate at the appropriate literacy level for the audience.
  • Create health literacy courses in Adult Basic Education, in K-12, and in training of all health care workers.

o   Establish health literacy learning standards across the lifespan.

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