Previously, we saw that low health literacy is a highly prevalent issue that negatively affects health outcomes. Now, we continue our exploration of health literacy, its negative effects on people, and possible solutions to address these issues.

So, first let’s ask the question: who is affected by low health literacy?

Low health literacy affects many Americans. A national literacy study estimated over 80 million Americans have limited health literacy. Additionally, while low health literacy can be found among any group of people, it’s most common among more vulnerable populations.

Compared to the 9% of white respondents who responded in the lowest category (below basic health literacy), 41% of Hispanic, 24% of Black, 13% of Asian, and 25% of American Indian and Native Alaskan respondents reported below basic health literacy.

Age and education are also big predictors. Over 29% of adults over the age of 65 reported below basic health literacy, compared to 10% of those 25–39. Alarmingly, almost 50% of those without a high school diploma are in the same group.

How does health literacy impact the healthcare system?

  • Low health literacy affects patients’ ability to:
  • Access services and navigate the healthcare system
  • Communicate effectively with healthcare providers
  • Seek preventive care, driving up healthcare costs
  • Understand directions on medicine and chronic condition management
  • Locate and understand health information online

Financial:Low health literacy leads to an extra cost burden on the American healthcare system. People with low health literacy are more likely to be hospitalized, more likely to use emergency services, and less likely to seek preventive measures such as vaccinations and mammograms.

Compliance:People with low health literacy have a more difficult time interpreting labels and health messages, leading to poorer medication adherence and behavior change.

Poor outcomes:Seniors with low health literacy experience poorer overall health outcomes and have higher mortality rates.

Who’s responsible for improving health literacy?

Often the responsibility of improving health literacy falls on providers, hospital employees, doctors, and nurses—members of the care team. This makes intuitive sense, as they have the most interaction with patients inside the hospital. However, if you focus your strategies inside the hospital, you miss the biggest opportunity to improve health literacy.

The fact is, most people don’t spend that much time inside the hospital, and when they do, it’s usually a stressful situation. As healthcare marketers, we have the unique power to engage patients outside the four walls of the hospital. Rather than waiting for people to walk in through the doors, we need to provide patient-centered content that fits people’s needs and help empower people in their own lives. Indeed, the most successful healthcare system of tomorrow will focus on educating patients and helping them manage their care and health journey.

We must all work together to ensure that health information and services can be understood and used by all Americans. As healthcare marketers, we have a major role to play in helping improving health literacy.

In our next post, we’ll look at content and design tactics to help address the challenges of health literacy. Stay tuned!


Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., Viera, A., Crotty, K., … & Tant, E. (2011). Health literacy interventions and outcomes: an updated systematic review. Evidence report/technology assessment, 199, 1-941.

Kutner, M., Greenburg, E., Jin, Y., & Paulsen, C. (2006). The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. NCES 2006-483. National Center for Education Statistics.

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