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  • Writer's pictureCommunity Wellbeing San Diego

Health Literacy: All Hands on Board

Health literacy is a widespread problem with growing complexities that cuts across various demographics and socioeconomic status groups. This issue has pushed the need for a focused and well-defined emphasis on health literacy to ultimately improve healthcare services. Public health efforts should emphasize health literacy's ability to break down healthcare barriers, taking into consideration the influence of diversity metrics such as race, ethnicity, and socioeconomic status.

Some efforts in clinical healthcare settings have been implemented to assess and test health literacy in patients using diagnostic tools such as the Test of Functional Health Literacy in Adults (TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM); however, they exhibit some limiting flaws with regards to their delivery assessment (DeWalt).

An article titled "Health Literacy: Challenges and Strategies" delves further into this topic by stating that the majority of available health information is written at a 12th grade reading level, which exceeds the 8th grade reading level of the average American. Thus, a patient’s health literacy score using the TOFHLA or REALM tests is incomplete without an assessment of the information delivered by the healthcare organization (Egbert & Nanna).

These assessment tools have certainly highlighted the quest for healthcare sectors to produce more accessible and easier-to-understand materials for all patients. This could include videos, picture-based messages, or text-based materials that are written at a lower reading level (Wilson-Stronks).

With the growing diversity in the United States, it is important to understand how racial/ethnic backgrounds, levels of education, socioeconomic statuses, income levels, access to healthcare, and cultural beliefs influence health literacy. This awareness and understanding will lay out a well-grounded foundation to develop and implement culturally-aligned programs.

DeWalt, D.A., Berkman, N.D., Sheridan, S., Lohr, K.N., & Pignone, M.P. (2004). Literacy and health outcomes. Journal of General Internal Medicine, 19, 1228-1239. Retrieved from

Egbert, N.& Nanna, K., (2009) "Health Literacy: Challenges and Strategies" OJIN: The Online Journal of Issues in NursingVol. 14, No. 3, Manuscript 1.DOI:10.3912/OJIN.Vol14No03Man01. Retrieved from

Wilson-Stronks, A., Lee, K. K., Cordero, C. L., Kopp, A. L., & Galvez, E. (2008). One size does not fit all: Meeting the health care needs of diverse populations. Oakbrook Terrace, IL: The Joint Commission. Retrieved from


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