Furthermore, limited health literacy is associated with reduced knowledge and uptake of prevention services such as immunisation and cancer screening programmes,66 70-72 and with less recall and adherence to medical instructions and self-care regimes.73-75
A systematic review found that people with lower literacy had less appropriate patterns of health service use and were not always able to secure appropriate treatment.76 When compared with people with adequate health literacy, people with limited health literacy generally enter the health system when they are sicker,77 are more likely to use emergency services, are more likely to be hospitalised with longer hospital visits, are less likely to use preventive services, and incur higher healthcare costs.66