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The health system and health professionals

The role of the health system and health professionals in relation to the demands and expectations made of patients for health literacy is explored.
© IMPACCT consortium

As previously stated there are many definitions of health literacy.

The 2009 WHO definition of Health Literacy was introduced earlier and is repeated here:

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.
Another, commonly used definition of Health Literacy, although dated, is from Kwan et al (2006) that states:
Health literacy is the degree to which people are able to access, understand, appraise and communicate information to engage with the demands of different health contexts in order to promote and maintain good health across the life-course.

Besides suggesting that health literacy is an issue for everyone, from childhood to old age, this definition includes a reference to the demands made of people in accessing and using health services and systems. This reflects the developing idea of health literacy as emerging from the interaction between the individual’s skills and abilities with the increasingly complex health care environment (Rudd, 2015. This interaction between the two elements situates health literacy as a relational concept (Pelikan 2014).

This focuses attention on the health system, health service and the health professional’s role in health literacy. It is not just about the skills and abilities of the individual, but the skills and abilities of the health professional in a health service environment that supports people in making informed decisions about their health.

List 5 demands health contexts make. These can be considered as barriers to peoples, access, understanding, appraisal and application of health information caused by health services and health professionals.

If you are interested in the range of definitions, have a look at this comprehensive review:

Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;72:80.


Kwan, B., Frankish, J., & Rootman, I. (2006). The development and validation of measures of “health literacy” in different populations. Vancouver: University of British Columbia Institute of Health Promotion Research & University of Victoria Centre for Community Health Promotion Research.

Nouri, S. S., & Rudd, R. E. (2015). Health literacy in the “oral exchange”: An important element of patient–provider communication. Patient education and counseling, 98(5), 565-571.

Pelikan, J. (2014). Measuring comprehensive health literacy in general populations. Presentation at HARC, Bethesda /Maryland, November. 4th 2014. Retrieved from

© IMPACCT consortium
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Working with Patients with Limited Health Literacy

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