Functional Health Literacy

Functional health literacy refers to individual level skills that move beyond readability. Functional health literacy includes skills necessary in the navigation of the complex health care system, includes prose, document and quantitative literacy and the ability to engage in the exchange of oral communication. Functional Health literacy also encompasses the skills and abilities known as health literacy - an individual's capacity to obtain, process and use health information and services to make decisions and take actions.

The relationship between literacy and health is complex; impacting health knowledge, health status, and access to health services. A person's level of functional health literacy directly affects his or her ability to navigate the health care system, share personal and health information with providers, engage in self-care and chronic disease management, adopt health promoting behaviors, and make judgments when faced with decision making regarding health-related information.

Individuals with inadequate functional health literacy often struggle with basic tasks when managing a chronic condition such as reading and comprehending prescription bottles, appointment slips, self-management and follow-up instructions, and disease-related brochures. Inadequate functional health literacy can be lead to poor health outcomes and increased health care costs.

Some populations are more likely to have lower functional health literacy than others. Most vulnerable are the elderly (age 65+), people living in poverty, those with lower educational attainment, underrepresented populations (African Americans and Hispanics); and immigrant populations with limited to no English proficiency. Many of the same populations at risk for limited functional health literacy have disproportionate rates of heart disease, diabetes, obesity, HIV/AIDS, cancer and death.

Key Facts

• According to the American Medical Association, poor health literacy is "a stronger predictor of a person's health than age, income, employment status, education level, and race"
• Inadequate health literacy is estimated to account for $50-73 billion per year in excess costs to the US health care system.

Who is Impacted?

Findings of Interest from the 2003 National Assessment of Adult Literacy (NAAL)

• The majority of adults (53%) had Intermediate health literacy. An additional 12% of adults had Proficient health literacy. Among the remaining adults, 22% had Basic health literacy, and 14% had Below Basic health literacy.
• Women had higher average health literacy than men; 16% of men had Below Basic health literacy compared with 12% of women.
• At every increasing level of self-reported overall health, adults had higher average health literacy than adults in the next lower level.