When we were young, we were instructed to wash our hands before and after eating. We did so without giving it a second thought. In school many of us used to have a health education period. In which, we were taught about hygiene, healthy eating, mental health among many other things. We learnt about germs and diseases. But most of us still did not wash our hands diligently. Now, thanks to COVID-19, we know “What”, “How” and “Why” of washing hands. Social media was flooded with information on washing hands. Some of them were true and some were not. As time passed by, we gained enough knowledge to differentiate between the facts and myths. Now most of us have mastered the skill of hand washing. What started as a task, has now become a habit.

This knowledge about maintaining our health or wellness is called health literacy. 

Health literacy refers to our ability to understand and use health information to make good and timely decisions about our health condition and disease.

CDC distinguishes two types of health literacy. 

Personal health literacy is the degree to which individuals have the ability to find, understand and use information and services to take health-related decisions and actions for themselves and others.

Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand and use information and services to take health-related decisions and actions for themselves and others.

Becoming health literate is a journey. We start by knowing the basics, then graduate to understanding the information. Finally, we become capable enough to use our knowledge to take prompt and right health decisions.

Levels of health Literacy

It would be ideal if we have a disease that we can play an active role in its treatment. It is especially important if it is a chronic disease like diabetes or hypertension that requires active patient engagement.

However, in reality many patients do not play an active role in the treatment of their health problems. We can find a spectrum with the patient being illiterate at one end, to the other end where patients are fully involved in the treatment or management of their health problems.

There are four levels of patient engagement. To learn about these levels, I request you to read my blog “Ten Simple Ways to Increase Patient Engagement and Improve Health Outcomes”. 

Nutbeam has identified three different levels of health literacy.

The first level is called “functional health literacy”. This is the basic level of health literacy. Patients in this level are content to read and understand health information that is given to them, may be in the form of a flyer or a brochure. They have no desire to actively search information to understand more about their health or disease. 

The second level is called “interactive or communicative health literacy”. Patients who are at this level, actively participate in everyday situations, take effort to extract health information either from printed material or online resources and derive meaning from them. Once they understand the information, they communicate with healthcare providers and to use the information to make decisions that work for them. 

The third level is called “critical health literacy”. This is the highest level. In addition to skills mentioned and interactive health literacy these patients have the ability to analyse and find out the reliability of information. This requires advanced thinking skills to analyze information and take decisions that give the patient more control over their health.

In a nutshell, Nutbeam’s three-level concept of health literacy implies that a person with higher health literacy level, is more capable of deciding and taking actions to improve their health.

How health literate are you?

Health literacy is very important. A person with better health literacy skills can be more independent and have more control over their health than a person with no or little skill. This can help them take better choices and improve their overall well-being.

There are several health literacy measurement tools that can be used to find out the general health literacy level. In addition, there are specific tools for certain diseases and population groups. Unfortunately, at present there are no simple tools available for the general public that is Open Access (free to access and use). Most of these tools are for research purpose only.

Are you eager to test your health literacy knowledge? 

Click on the link to participate in the health literacy quiz. 


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