Who is this guide for?
The Quick Guide to Health Literacy and Older
Adults is for people who serve older adults on health and aging issues.
The guide provides background information on health literacy and strategies and
suggestions for communicating with older adults. Links to many helpful resource
materials are included for you to investigate specific topics in greater
detail. This guide builds on the information presented in the Quick Guide
to Health Literacy, published by the U.S. Department of Health and Human
Why are the health literacy
needs of older adults important?
Problems with health literacy affect millions of
Americans, including older adults. More than 77 million U.S. adults have basic
or below basic health literacy skills.1 For the
growing population of older Americans aged 65 years or olderexpected to
reach more than 71 million by 20302difficulties with health literacy can complicate
already challenging health problems.
What is health literacy?
Health literacy has to do with how well people
understand and are able to use health information to take action on their
health. More than just the ability to read and write, health literacy includes
the ability to listen, follow directions, fill out forms, calculate using basic
math, and interact with professionals and health care settings. It can also
include making sense of jargon or unfamiliar cultural norms. Health literacy
requires people to apply critical thinking skills to health-related
Health literacy has been defined as "the degree to
which individuals have the capacity to obtain, process, and understand basic
health information and services needed to make appropriate health
decisions."5 A person's health literacy is
influenced by a number of factors, including basic literacy skills, the
communication skills of health professionals, and the situations one encounters
in the health care system.6 These issues affect
how a person finds a doctor, reads instructions for medicine, or takes other
health-related action.6 Also, to take such action
people often need a realistic understanding of health and disease. People with
low health literacy skills often lack such knowledge.6
Anyone can have low health literacy, including
people with good literacy skills. In fact, most people will have trouble
understanding health information at some point in their lives. For example,
people experiencing serious health problems may come across specific medical
terms or health information for the first time.4
National Assessment of Adult
Older adults have documented
health literacy problems. The 2003 National Assessment of Adult Literacy
included the first-ever national assessment of health literacy, which found
that adults age 65 and older have lower health literacy scores than all other
age groups surveyed. Only 3 percent of the older adults who were surveyed were
measured as proficient.
As you work to improve the health of older adults,
you need to be aware of their health literacy needs. Here's why:
- Health outcomes are related to health literacy.
Studies have shown that patients with low health literacy have trouble
understanding health information and getting preventative health care. These
patients may use emergency rooms and other expensive health services more often
than patients with higher health literacy skills.4
- As many as 80 percent of older Americans have
at least one chronic health condition.7 The
more health conditions people have, the more they need to navigate the health
care system and interpret complex health information. These tasks are
challenging for people with low health literacy. Particular challenges for some
older adults are accessing health information on the Internet and using basic
- Literacy problems will not always be obvious to
you. Some people hide their problem out of shame, or they may not recognize the
difficulty they have with reading. Such individuals may not ask important
health questions, or they may misunderstand a health care provider's
The Quick Guide to Health Literacy
includes a basic overview of health literacy, techniques for improving health
literacy, and examples of health literacy best practices. This resource may be
especially helpful to people who are looking for assistance on a range of
health literacy issues. The guide can be found at
What special issues apply to
The following sections address health conditions
that can impact older adults' health literacy. Highlights of effective
strategies and suggestions for you to consider when communicating and working
with older adults are included. Adjusting the way you communicate may help
older adults increase health literacy skills.
Note: Be sensitive to cultural, language,
and other differences among the older adults you serve. Some suggestions in
this guide may not be appropriate for everyone.
- Kutner M, Greenberg E, Jin Y,
Paulsen C. The Health
Literacy of America's Adults: Results From the 2003 National Assessment of
Adult Literacy (NCES483). U.S. Department of Education.
Washington, DC: National Center for Education Statistics; 2006.
- U.S. Administration on Aging.
Statistics on the Aging Population. Available at
www.aoa.gov. Accessed July 2007.
- National Library of
Medicine. Health Literacy. Available at
Accessed July 2007.
- Institute of Medicine.
Health Literacy: A Prescription to
Washington, DC: National Academies Press; 2004.
- U.S. Department of Health
and Human Services. Healthy People
2010. Washington, DC: U.S. Government Printing Office. 2000.
Originally developed for Ratzan SC, Parker RM. Introduction. In National
Library of Medicine Current Bibliographies in Medicine: Health Literacy.
Selden CR, Zorn M, Ratzan SC, Parker RM, Editors. NLM Pub. No. CBM 20001.
Bethesda, MD: National Institutes of Health, U.S. Department of Health and
Human Services; 2000.
- U.S. Department of Health and
Human Services, Office of Disease Prevention and Health Promotion. Quick
Guide to Health Literacy. Available at
Accessed July 2007.
- Centers for Disease Control
and Prevention and the Merck Company Foundation. The State of Aging and
Health in America 2007: Executive Summary. Whitehouse Station, NJ: The
Merck Foundation; 2007.
- Information included here
with the expert guidance of Elias JW, University of California, Davis.
- Parker R. Health literacy: a
challenge for American patients and their health care providers. Health
Promotion International. Oxford University Press.