as the field of health literacy expands in scope and breadth, the term health literacy continues to have a plethora of meanings depending on whom you are speaking to and the context of reference. It can have an extremely broad reference, such as when referring to the health literacy environment of a health care organization or health care system. Health literacy can also have a very specific reference, such as when referring to an individual's health literacy skills when visiting a physician's office for the first time or accessing an erner• gency department for acute chest pain.