Previous studies have suggested that inadequate health literacy is linked to worse knowledge of proper health behaviors and lower adherence to medical instructions; that despite access to health care the quality of medical encounters may be compromised when health care providers do not communicate at a level that is understood; and that patient education materials may be too complex or written at too high a level to be helpful. "Over time, these factors could contribute to the worse health status seen among the older patients with low health literacy in this study," the authors suggest.

"Although the causal pathways between low health literacy and disease-specific health outcomes remain unclear, this study provides further evidence of the likelihood that inadequate health literacy detrimentally affects health," the authors conclude. "To develop appropriate and responsive interventions, future studies should discern how adults with lower health literacy recognize health issues, and they should identify barriers to seeking out appropriate health care services. In addition, interventions are needed that can help physicians and other health care professionals recognize and address the special needs of patients with limited health literacy."

(Arch Intern Med. 2005; 165: 1946-1952. Available pre-embargo to media at www.jamamedia.org.)

Editor's Note: Dr. Wolf was supported by a career development award from the Centers for Disease Control and Prevention, Atlanta, Ga.

Editorial: Reading is Fundamental The Relationship Between Literacy and Health

In an editorial accompanying the article, Darren A. DeWalt, M.D., M.P.H., and Michael P. Pignone, M.D., M.P.H., of the Unive
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Contact: Liz Crown
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JAMA and Archives Journals
26-Sep-2005