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Myths and Realities

Studies that have investigated the issue report that limited literacy skills are a stronger predictor of an individual's health status than age, income, employment status, education level, and racial or ethnic group.

What is health literacy?
Health literacy is the ability to read, understand and effectively use basic medical instructions and information. Low health literacy can affect anyone of any age, ethnicity, background or education level.

Why is it important to me?
Chances are high that you or someone you know may be among the 90 million people in the United States whose health may be at risk because of difficulty in understanding and acting on health information.

People who have low health literacy:

  • Are often embarrassed or ashamed to admit that they have difficulty understanding health information and instructions.
  • Use well-practiced coping mechanisms that effectively mask their problem.

Patients are encouraged to understand the answers to three questions:

  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do this?

Myth vs. reality

As an emerging public health issue, low health literacy is often misunderstood as a condition that affects a small, specific portion of the population. In reality, its scope is much broader and its impact much more severe.

Myth: Most people with low literacy skills come from minority backgrounds.

Reality: Although ethnic minority groups are disproportionately affected by low literacy, the majority of those with low literacy skills in the United States are white, native-born Americans.


Others who are especially vulnerable in a health care situation include:

  • Older patients
  • Recent immigrants
  • People with chronic disease
  • Those with low socio-economic status

Myth: Most patients are generally well read and college-educated.

Reality: The average American reads at the 8th-9th grade level; however, health information is usually written at a higher reading level. Most patients - regardless of their reading or language skills - prefer medical information that is simple and easy to understand.

Additional factors that may hinder understanding include:

  • Intimidation, fear, vulnerability
  • Shock upon hearing a diagnosis
  • Extenuating stress within the patient's family
  • Multiple health conditions to understand and treat

Ask Me 3 is an educational program provided by the Partnership for Clear Health Communication to promote clear communication between health care providers and patients. The partnership is a coalition of national organizations that are working together to promote awareness and solutions around the issue of low health literacy and its effect on health outcomes. Materials to encourage patients to Ask Me 3, as well as research and literacy resources, are available on the National Patient Safety Foundation website or by calling 1-8777-4-ASK-ME-3.

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