Promoting Health Literacy as an Important Initiative in Reducing Health Disparities and Advancing Health Equity

Abstract

Health literacy is increasingly being recognized as an important social determinant of health and a key initiative to reduce health disparities and promote health equity at global, national, regional, and local levels. We provide new definitions of health literacy covering both personal and organizational aspects. Individuals’ ability to use health information rather than just understand it in order to make informed decisions about their health and health care are the hallmarks of these definitions. The new definitions acknowledge the importance of organizations addressing health literacy themselves as patients should not be solely responsible for health literacy. Our analyses of two recent US databases, the 2016 Behavioral Risk Factor Surveillance System and the 2022 Health Center Patient Survey, show striking racial/ethnic and socioeconomic disparities in health literacy levels and consequent health impacts. Compared to White Americans, Asians, Native Hawaiians and Pacific Islanders, and Hispanics have markedly lower levels of health literacy as they experience greater difficulties in obtaining health information, understanding written health information, and information they receive from healthcare providers. Education and income gradients in health literacy are steep. Americans in the lowest education and income strata have 7 to 10 times greater difficulty in receiving needed medical advice or health information than those at the highest education and income levels; they score 17–20 points lower on the health literacy index than their counterparts with high education or income levels. Patients who do not receive easy-to-understand health information from their healthcare providers have significantly increased risks of poor health, serious psychological distress, and emergency care. We discuss social and health benefits and strategies for improving health literacy.