Health Literacy

Risk of limited Health Literacy

There has been many studies that have identified certain groups at high risk of poor health literacy:

65 years old

recent immigrants and other minority groups

low income



low education levels

Although low literacy is more prevalent in some populations, limited health literacy is seen in all sociodemographic groups. Therefore, a patient’s health literacy should never be assumed.

Identifying patients who may be at risk of poor health literacy is the first step in bridging gaps in understanding between the health provider and the patient. Many studies have shown that low health literacy is linked to poor health outcomes.


1. Baker GR. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. Can Med Assoc J. 2004;170(11):1678-1686.

2. Berkman N, Sheridan S. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97-107

3. Davis, T. C., Wolf, M. S., Bass, P. F., Middlebrooks, M., Kennen, E., Baker, D. W., … Parker, R. M. (2006). Low literacy impairs comprehension of prescription drug warning labels. Journal of General Internal Medicine, 21(8), 847–51.

4. Wolf, M. S., Davis, T. C., Shrank, W., Rapp, D. N., Bass, P. F., Connor, U. M., … Parker, R. M. (2007). To err is human: Patient misinterpretations of prescription drug label instructions. Patient Education and Counseling, 67(3), 293–300.

5. Sørensen K, Van den Broucke S, Fullam J, et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health. 2012;12(1):80. doi:10.1186/1471-2458-12-80.

6. Nielson-Bohlman L, Panzer A, Kindig D, eds. Health Literacy: A Prescription to End Confusion. Washington, DC: National Academies Press; 2004/