The term health literacy was first used in 1974 to describe how health information impacts the educational system, the health care system, and mass communication and was used as a goal to be established for grades K through 12 (AMA, 2005, p. 4). 111e concept of health literacy was not introduced into health care litera• ture until the 1990s and the emphasis on self-management of health and disease in the early 2000s has placed more of a focus on an individual's health literacy skills (Cutilli & Bennett, 2009). Health literacy as a concept has progressed from describing and defining the literacy skills of the adult population to the under• standing that adequate, if not advanced, literacy skills are necessary to access, navigate, and understand the health care system of today.