Another Hidden Epidemic: Limited Health Literacy

Barbara A. DeBuono, MD, MPH


November 06, 2006


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What factor is the strongest predictor of an individual's health status? Age? Income level? Education? Ethnicity? Literacy skills? Would it surprise you to know that it's literacy skills? Specifically, health literacy: the ability to read, understand, and act on health information.

According to the 2003 National Assessment of Adult Literacy, 30 million Americans have literacy skills defined as "below basic." Individuals at this level have difficulty comprehending directions for taking medicine or understanding an appointment slip. Another 63 million are at the "basic" level. These individuals find it difficult to calculate a dose of an over-the-counter medication for a child or comprehend a consent form.

While some groups, notably the elderly and poor, are at particularly high risk for limited literacy, people of all ages, nationalities, and income groups are at risk. Most of the almost 50% of the US population in the below basic and basic literacy levels are native-born, white adults.

The Partnership for Clear Health Communication ( is a national, nonprofit coalition of organizations working to build awareness and advance solutions to improve health literacy and to positively impact health outcomes.

One of our solutions is Ask Me 3, a simple tool that encourages patients to ask 3 questions at every healthcare encounter: What is my main problem? What do I need to do? Why is it important for me to do this?

Our literature is available on our Web site in both English and Spanish ( Contact us and empower your patients to ask questions.

That's my opinion. I'm Dr. Barbara DeBuono, Senior Medical Advisor for Public Health and Policy at Pfizer and Chair of the Board of the Partnership for Clear Health Communication.


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