Outcomes Systematic Review of the Literature Background and Objectives for the Systematic Review Background

Health literacy, as defined by the Institute of Medicine (IOM) in 2004, is “the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. ” This capacity includes the ability to interpret documents, read and write prose (print literacy), use quantitative information (numeracy), and speak and listen effectively (oral literacy) in a health care setting. In 2003, the US Department of Education conducted a survey entitled “National Assessment of Adult Literacy ” (NAAL). The most comprehensive examination of adult literacy to date, the NAAL surveyed more than 19,000 adults aged 16 and older. The assessment included items intended to directly measure health literacy. More than one-third of respondents (36%) scored in the lowest two categories (“basic ” and “below basic”), suggesting that approximately 80 million adults in the United States have limited health literacy.1 These people may have difficulty with even simple tasks like reading and understanding the instructions on a prescription bottle or filling out an insurance form. Low health literacy skills are more common in certain subgroups, including minorities, the elderly, Medicaid recipients, and people who have not completed high school