The Calgary Charter on Health Literacy: Rationale and Core Principles for the Development of Health Literacy Curricula

Written by an international and multi-disciplinary team of health literacy advocates, this charter outlines a new definition of health literacy and also a set of its core principles. 

Clifford Coleman, M.D.
Sabrina Kurtz-Rossi, M.Ed.
Julie McKinney, M.S.
Andrew Pleasant, Ph.D.
Irving Rootman, Ph.D.
Linda Shohet, Ph.D.
Author(s) Organizational Affiliation
The Centre for Literacy of Quebec
Publication Year
Resource Type
Informational Material
Number of Pages

Written by an international and multi-disciplinary team of health literacy advocates, this charter outlines a new definition of health literacy and also a set of its core principles. It is intended to help guide the development of new health literacy curricula for both the public and health professionals in a way that adheres to a consistent concept of health literacy. However, it has value beyond curriculum development in that it offers a theoretical concept that reflects the two-way-street aspect of health literacy in a way that other definitions have not. In other words, it shows how health literacy applies to both information seekers (i.e. patients, adult learners, etc.) and information givers (i.e. health care providers, the public health system, etc.)

This Charter can be used by adult educators to ensure that the way they teach health literacy is consistent with the current understanding. It also highlights aspects of health literacy that can be served particularly well by the adult education approach. For example, it notes the importance of an understanding of the power dynamic between the public and the health care system, and the need for not just knowledge of health, but also the ability and confidence to ask questions and reach a level where one can use new skills and information to take action. Adult literacy programs can address each of the components of health literacy outlined in the charter: finding information, understanding it, evaluating it, communicating it, and using it to improve health.

This is also a good basis for partnering between adult education and health programs, because it addresses skills and attitudes that both partners must enhance in order to improve the health literacy of their community.

What the experts say

The Calgary Charter clearly outlines that health literacy is more than teaching adult learners how to communicate about health information and the need to develop health information in plain language. Adult Education professionals benefit from the delineation of plain language, health communication, and health literacy.

As the authors’ point out, health literacy curricula should:

  1. take an integrated approach to the social, cultural, political, economic, and environmental determinants of health in order to effectively address the complex paths to better health, and
  2. attempt to take account of the skills and abilities associated with individual health literacy and the cultural, social, economic, and policy issues associated with health systems.

Thus, the Calgary Charter provides a “road-map” or “blue print” to guide Adult Education professionals as they develop health literacy curricula and integrate it into their instructional program.

The theoretical base of the Calgary Charter is two-fold, and comes from research in education and sociology. First, Freire’s (1970) pedagogical philosophy is clearly evident as health literacy includes an awareness of and ability to: 1) navigate differences between the cultures of the health system and the public, and 2) minimize the power imbalances between the health system and the public. Second, Link and Phelan’s (1995) Fundamental Causes framework highlights that an individual’s health outcomes occur through the connection and interaction between individuals’ health literacy and the health literacy of health care systems/organizations.

Useful Features of the Charter include:

  1. a concise set of rationale and core principles to develop and evaluate health literacy curricula,
  2. a holistic definition of health literacy,
  3. a focus on individual, provider, and system/organization health literacy.

Please note that this resource is a charter, and not a scholarly article. As such, it does not provide citations for its theoretical base. Note also, that it is a framework for core principles of health literacy, which the authors and signatories suggest incorporating into all health literacy curricula. It does not address a course of action or include resources for creating such curricula. For those who want more guidance in this area, please see the following resources:

Health Literacy Special Collection

Health Literacy in Adult Basic Education: Designing Lessons, Units and Evaluation Plans for an Integrated Curriculum

Integrating Health Across the Curriculum: A Guide for Program Directors in Adult Basic Education

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