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The architecture of health literacy

In this article we will explore the components and concepts of health literacy as embodied in health literacy definitions.
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© IMPACCT consortium

At this point you have explored four components found in many definitions of health literacy, each illustrated in one of the four short videos. The themes that have been touched on include, people’s access to health services, their understanding of health information as well as their evaluation and use of health information.

These core elements can all be considered in the context of health literacy and are often referred to as:

  • Access / obtain health information
  • Understand health information
  • Process/appraise health information
  • Apply/use health information. (Pleasant, 2014)

These four core elements may appear quite straight forward but health literacy is more than this. It is a multidimensional complex social construct (Pleasant, 2014) with multiple definitions which have, and continue to, broaden and evolve over time (Batterham et al., 2016).

When people hear the term health literacy they generally focus on the word literacy and think about people’s abilities, or more likely, their inability to read and write. Health literacy does include basic literacy skills like reading and writing, but has developed to include numeracy and other skills and abilities. This is reflected in the World Health Organization’s definition of Health Literacy from 2009 which states:

Health Literacy has been defined as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Health Literacy means more than being able to read pamphlets and successfully make appointments. By improving people’s access to health information and their capacity to use it effectively, health literacy is critical to empowerment.

WHO, 7th Global Conference on Health Promotion Nairobi 2009

Read this page which presents the WHO’s Mandate for Health Literacy from the WHO, 9th Global Conference on Health Promotion, Shanghai 2016. This WHO definition and mandate demonstrate that health literacy is more than about an inability or deficit in reading and writing. It has developed to include numeracy as well as other skills and abilities, such as listening and critical analysis.

As WHO recognises health literacy has a critical role to play in empowering people to take control of their health, individually and collectively. As such health literacy has been considered as an asset for health, to be developed (Nutbeam, 2008).


Pleasant, A. (2014). Advancing Health Literacy Measurement: A Pathway to Better Health and Health System Performance. Journal of Health Communication. 19(12): 1481–1496. doi: 10.1080/10810730.2014.954083

Batterham, R.W., Hawkins, M., Collins, P.A., Buchbinder, R., & Osborne, R.H. (2016). Health literacy: applying current concepts to improve health services and reduce health inequalities. Public Health. 32:3-12. doi: 10.1016/j.puhe.2016.01.001

Nutbeam, D. (2008). The evolving concept of Health Literacy. Social Science and Medicine, 67(12)2072-2078. doi: 10.1016/j.socscimed.2008.09.050.

© IMPACCT consortium
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