Iowa Healthcare Collaborative

Health literacy is the ability to obtain, process, and understand basic health information and services to make appropriate health decisions. Health literacy goes beyond simple literacy and the ability to read and write information provided to you, but rather encompasses social and individual factors, listening and speaking skills, numerical and mathematical knowledge, and conceptual knowledge in addition to basic reading and writing skills.  An estimated 90 million Americans are considered to have limited health literacy and only 12% of Americans have the health literacy skill to perform complex health tasks [1-2]. A health literate society could save excess health care costs estimated between $106-239 billion annually [3]. (See Footnotes)

Educational Resources

Always Use Teach-Back Toolkit (Link)
The purpose of the "Always Use Teach-back!" Toolkit is to help all healthcare providers learn to use teach-back—every time it is indicated—to support patients and families throughout the care continuum, especially during transitions between health care settings. It combines health literacy principles of plain language and using teach-back to confirm understanding, with behavior change principles of coaching to new habits and adapting systems to promote consistent use of key practices.

Health Literacy (Video)
The American College of Physicians (ACP) developed this video to review issues involved with health literacy.

Improving Health Literacy for Older Adults (PDF)
The Centers for Disease Control and Prevention (CDC) convened an expert panel on improving health literacy in older adults to develop an agenda that will improve health literacy for all U.S. population groups. Providers are encouraged to really focus on helping the elderly since they have the lowest relative health literacy for any population group in the United States.

Path to Improvement (PDF)
Providers can use this six step guideline, from the North Carolina Program on Health Literacy, to address health literacy within their organization. 

Plain Language (Link)
This website is a great tool for providers that can help them communicate complex medical information to their patients. The "Tips & Tools" section is especially helpful. 

Simply Put: A Guide for Creating Easy-to-Understand Materials (PDF)
The CDC offers a guide to help providers transform complicated scientific and technical information into communication materials that general audiences can relate to and understand.

Ten Attributes of Health Literate Health Care Organizations (PDF)
This article describes ten attributes of health literate health care organizations that providers can use to help improve health literacy in their respective organizations.


Printable Resources

How to Communicate so Your Patients Understand (PDF)
The Kentucky Hospital Association created this printable brochure to help providers improve communication methods when discussing medical treatment and care with patients. 

Health Literacy Infographic (PDF)
This infographic, from Communicate Health, offers an easy way to understand the issues surrounding health literacy within our society.

Health Literacy for Older Adults (PDF)
Providers can use this self-assessment, from the CDC, to check how well they are doing in addressing health literacy issues with older adult patients.

Rapid Estimate of Adult Literacy in Medicine (REALM-SF) (PDF)
The REALM short form can be used by clinicians to evaluate the health literacy levels of each patient. Please follow this link for how to use the form on the AHRQ website.

Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50) (PDF)
This health literacy assessment tool was designed for providers to assess a Spanish-speaking adult’s health literacy level. Please follow this link for how to use the form on the AHRQ website.


  1. Institute of Medicine. (2004). Health literacy a prescription to end confusion. Washington, D.C.: National Academies Press.

  2. Kutner, et al. (2006). The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy.

  3. Vernon, J. A., Trujillo, A., Rosenbaum, S., & DeBuono, B. (2007). Low health literacy: Implications for national health policy.  Washington, DC: Department of Health Policy, School of Public Health and Health Services, The George Washington University.

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