readability ofthe printed materials thatthey
are using and to make conscious efforts to
minimise the use of technical language,
using lay terminology whenever possible.
Not surprisingly, research on health
literacy over the past decade has shown
that those who have poor health literacy
are less responsive to health education
and use of disease prevention services,
less able to manage successfully chronic
disorders, such as diabetes and asthma,
and incur higher healthcare costs.
8,18
This
research has led to progressive testing of
interventions designed to mitigate the
effects of poor health literacy through
modified communications, and improved
service organisation.
19
For these reasons,
understanding the concept of health
literacy, and the research that underpins
the concept are especially important in
achieving current UK priorities to promote
greater patient participation in health care
and to achieve greater equity in health
outcomes.
Perhaps more challenging still,
Kickbusch et al have argued that health
literacy is ‘a critical empowerment strategy
to increase people’s control over their
health, their ability to seek out information
and their ability to take responsibility’.
20
Healthcare professionals and patients have
vastly different status and roles in
healthcare interactions. In addition to
improving health literacy, there is a need
for a more symmetrical balance of ‘power’
to encourage relationships that actively
foster joint decision making and, therefore,
facilitate genuine participation in decision
making.
Disappointingly, there has been little
research into health literacy in the UK. The
National Consumer Council (now referred
to as ‘Consumer Focus’) reported that low
health literacy appears to be particularly
prevalent among lower socioeconomic
groups, ethnic minorities, older people,
and those with chronic conditions or
disabilities.
21
This reduced ability to access
information and function effectively in the
current health service may be an
explanatory factor in health inequalities.
22
Reviewing the evidence, the American
Medical Association found that health
literacy is a stronger predictor of health
status than age, income, employment
status, education level, race, or ethnic