About Health Literacy


Analphabet: A person who cannot read, does not know the alphabet. An illiterate person.
Source: Merriam-Webster Online Dictionary. Analphabet. http://www.merriam-webster.com/dictionary/analphabet. Retrieved 30 March 2012. 

Literacy: “Literacy is the ability to identify, understand, interpret, create, communicate and compute, using printed and written materials associated with varying contexts. Literacy involves a continuum of learning in enabling individuals to achieve their goals, to develop their knowledge and potential, and to participate fully in their community and wider society.”
Source: UNESCO. The Plurality of Literacy and its implications for Policies and Programs. UNESCO Education Sector Position Paper: 13. 2004. Available at: http://unesdoc.unesco.org/images/0013/001362/136246e.pdf

Health literacy: "The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions"
Source: U.S. Department of Health and Human Services (USDHHS). Quick guide to health literacy: health literacy basics. Available at: http://www.health.gov/communication/literacy/quickguide/factsbasic.htm. Retrieved 30 March 2012.

Pictograms: is an image “that conveys its meaning through its pictorial resemblance to a physical object”
Source: Pictograms. Wikipedia. April 18, 2012. Available at: http://en.wikipedia.org/wiki/Pictograms. Retrieved 30 March 2012



In a world of global marketing and communication technologies, even in a remote village you will find someone who recognizes a corporate logo. The tragic irony is that these same people will not understand some of the simplest concepts about their own health.

The UNESCO Institute of Statistics reports that the overall adult literacy rate is 83.7% as of 2009. Naturally there is huge disparity depending on the region of the world you are looking at.


Figure 1 Adult literacy rates around the world
[Source: World Literacy Rates. http://en.wikipedia.org/wiki/File:Literacy_rate_world.PNG. Retrieved 13 April 2012]

These statistics are misleading as they only factor in individuals that possess basic reading and writing skills. What they do not account for is how well individuals understand health information.

There are countless prescription drugs on the market. Each drug may have multiple indications and intricate administration instructions. It is no surprise that patients are left confused about their drugs. For example, asthmatics with poor health literacy skills have a decreased understanding of how to manage their disease which results in more asthma exacerbations and more hospitalizations [Williams, M.V., Baker, D.W., Honig, E.G., Lee, T.M. and Nowlan, A. (1998) Inadequate literacy is a barrier to asthma knowledge and self‐care. Chest, 114, 1008-15.]. This concept is also applicable to disease states such as diabetes mellitus, COPD, heart failure and many other conditions [Gazmararian, J.A., Williams, M.V., Peel, J. and Baker, D.W. (2003) Health literacy and knowledge of chronic disease. Patient Educ Couns, 51, 267‐75]. Individuals with low literacy levels are more likely to misinterpret medication instructions but even those with adequate literacy skills have a one-in-three chance of misinterpreting instructions [Wolf, M.S., Davis, T.C., Shrank, W., Rapp, D.N., Bass, P.F., Connor, U.M., Clayman, M. and Parker, R.M. (2007) To err is human: patient misinterpretations of prescription drug label instructions. Patient Educ Couns, 67, 293‐300].

Moreover, the literacy levels of mothers have a direct impact on the child’s growth and cognitive development. As the time in formal education increases, the incidences of illness decrease in children - there is better immunization status, better nutrition and performance on cognitive tests. Mothers with education are more active in implementing health practices, have greater access to information and a greater voice in family health decisions [Saima, A et al. Effect of Maternal Literacy on Child Health: Myth or Reality. (2011)  Ann Pak Inst Med Sci. 7(2): 100-103].

The International Pharmaceutical Federation (FIP) attempts to bring a high level of recognition to health literacy. While there are many ways to tackle health illiteracy, the Military and Emergency Pharmacy Section (MEPS) of the FIP is undertaking a major project in developing clear, easy-to-understand prescription labels using pictograms. These labels will contain pictograms that would accompany written and/or verbal health information for medications. The FIP’s position on medication encourages pharmacists and other health care professionals to routinely educate patients and those providing care for patients. This promotes understanding and proper use of medicines and related aids for administration. [You may refer to the FIP STATEMENT OF PROFESSIONAL STANDARDS - MEDICATION ERRORS ASSOCIATED WITH PRESCRIBED MEDICATION]

These pictograms will assist patients to remember how to take their medications and understand health information easier. Graphic symbols for patient instruction should not be used alone but should always be combined with written instructions. [You may refer to the FIP GUIDELINES FOR THE LABELS OF PRESCRIBED MEDICINES].