The World Health Organization defines health literacy as: the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health.
In other words, although it is often thought of as relating only to reading, it includes understanding and analysing information; decoding instructions, symbols, charts, and diagrams; weighing risks and benefits; and, ultimately, making decisions and taking action.
The level of health literacy that a person needs varies according to the complexity of the information they have to understand, the decisions they have to make, and the health-related tasks they have to undertake. The more complex a person’s health – for example managing multiple long term conditions – the greater the skills and abilities they need.
Taking into account these different skills and capabilities, health literacy affects people’s ability to access health services, navigate the healthcare system, share personal information, such as their health history, engage in decision-making and manage their own health.
When understood in the context of these activities, health literacy has implications for how individual health professionals and health services more broadly support people. Therefore, whilst the concept of health literacy was previously framed as a deficit in individuals, and the ‘solution’ to it was therefore seen as lying with people using services, it is increasingly being viewed as a framework for understanding how competent organisations are at responding to the needs of the people they serve.
Providing services that are competent in meeting people’s health literacy needs is a part of person-centred care because it means taking into account people’s individual health literacy in order to provide care that is personalized and enabling. That means health professionals in the consultation working in ways that are tailored to individual needs, and services that are designed and provided in ways that ensure they meet the need of populations with a range of health literacy skills. Furthermore, understanding the health literacy of the local population can provide a new perspective on the quality of care, which can in turn drive improvement in systems and practice and potentially reduce health inequalities. Viewed in this way, health literacy is not about the abilities of the individual, but about the responsiveness of the system.