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Literacy and Health Literacy

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Why raise the issue literacy?

Literacy and numeracy status is assessed at the beginning of the consultation to ensure communication, information or support is appropriate for individuals whose literacy or numeracy skills are otherwise potential barriers to their full participation.

Evidence shows that patients with low literacy

  • Are more likely to have poor physical and mental well-being
  • Are less likely to be aware and make use of prevention facilities.
  • Are less able to self manage
  • Are less likely to adhere to prescribed courses of treatment. 
  • Have poorer health outcomes including knowledge, intermediate disease markers, and measures of morbidity.
    • People with diabetes and poor literacy skills have been shown to have higher levels of retinopathy and lower levels of blood sugar control
    • People with COPD and poor health literacy have been shown to experience greater COPD severity, higher learned helplessness, poorer respiratory-specific and general health status, and greater risk of COPD-related hospitalisation
  • Men with lower literacy levels who drank alcohol were also more likely to consume a higher number of units than those with good skills. 
  • Are more likely to smoke cigarettes 
  • Women with literacy and numeracy issues are four times more likely to experience homelessness


How to raise the issue of literacy

Identify any issues

  • Ask: “How often do you need to have someone help you with understanding forms, letters, or medicine labels?”
  • If patient responds either “sometimes” or more often than sometimes, this is a positive indicator of some degree of difficulty with literacy and/or numeracy. 
  • Reassure your patient by letting them know that many people have difficulty reading and understanding medical information. 
  • If they have any type of literacy difficulty, consider in consultation with the patient simple adaptations that may support the consultation and their preferred format for future communications (e.g. phone call instead of letters).
  • Please ensure that literacy issues are considered as part of the holistic agenda setting discussion in the Health Behaviours and Life Circumstances part of the consultation.


Health Literacy

  • Health Literacy can affect anyone at any time for example receiving new or distressing health information.
  • People living with long term conditions may be required to deal with larger amounts of technical information about their condition and their care.
  • Health Literacy is about people having enough knowledge, understanding, skills and confidence to use health information, to be more active partners in their care, and to navigate health and social care system
  • Never make assumptions about a person’s health literacy level as it may not always be apparent


The Health Literacy Place has more information and range of tools which can support your conversation. 


Referral to Services
For information about local services please access Health and Wellbeing Directory.

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Last Updated: 21 July 2020