Health literacy is a set of skills that people need to function effectively in the health care environment. These skills include reading and understanding text, locating information in documents, using numerical information (for example, measuring, counting, and ratios), and speaking and listening effectively. In our article, my colleagues and I examined the relationship between relative shortcomings in these skills (referred to as low health literacy) and poorer health outcomes.

On the basis of our systematic review of 96 studies, we agree with Dr. Rudd that future studies including analytic frameworks that thoughtfully conceptualize the link between individuals' health ...


  • 1. Berkman NDSheridan SLDonahue KEHalpern DJViera ACrotty Ket alHealth Literacy Interventions and Outcomes: An Updated Systematic Review. RTI International–University of North Carolina Evidence-based Practice Center contract no. 290-2007-10056-I. Agency for Healthcare Research and Quality Evidence Report/Technology Assessment no. 199. Publication no. 11-E006. Rockville, MD: Agency for Healthcare Research and Quality; 2011. Google Scholar
  • 2. Sheridan SLHalpern DJViera AJBerkman NDDonahue KECrotty KInterventions for individuals with low health literacy: a systematic review. J Health Commun2011;16 Suppl 3 30-54. [PMID: 21951242] CrossrefMedlineGoogle Scholar
  • 3. Rosenfeld LRudd REmmons KMAcevedo-García DMartin LBuka SBeyond reading alone: the relationship between aural literacy and asthma management. Patient Educ Couns2011;82:110-6. [PMID: 20399060] CrossrefMedlineGoogle Scholar
  • 4. Martin LTSchonlau MHaas ADerose KPRudd RLoucks EBet alLiteracy skills and calculated 10-year risk of coronary heart disease. J Gen Intern Med2011;26:45-50. [PMID: 20809155] CrossrefMedlineGoogle Scholar