A Prescription Is Not Enough: Improving Public Health with Health Literacy

This article focuses on the use—and the lack of use—of health literacy within efforts to address public health in the United States.

Andrew Pleasant, Ph.D
Jennifer Cabe, M.A.
Laurie Martin, Sc.D., M.P.H.
R.V. Rikard, Ph.D.
Author(s) Organizational Affiliation
Canyon Ranch Institute
RAND Corporation
North Carolina State University
Publication Year
Resource Type
Instructional Material
Number of Pages
Product Type

Health literacy is always present, but too often neglected. This article focuses on the use—and the lack of use—of health literacy within efforts to address public health in the United States. While a growing body of evidence strongly suggests that health literacy can be effective in public health when explicitly addressed, the concept and associated best practices of health literacy do not seem to be consistently or universally used within public health organizations. This report examines efforts specific initiatives within state, local, tribal, and territorial public health organizations to improve public health through increased health literacy. Case studies are provided from Louisiana, Nebraska, and Arkansas.  The report also includes findings from a survey of public health professionals, a discussion of the utility of health literacy to public health, and recommendations for moving forward.

What the experts say

This is a valuable document for framing health literacy as an overarching perspective for tackling public health inequities and related challenges. This article makes a strong case for how adult basic education could be a key factor in improving the nation’s health. It describes the poor state of health in the U.S. as compared to other developed countries and how health literacy can be seen as a route to behavior change that can improve individual and public health.

The most beneficial part of the document is the description of the Calgary Charter on Health Literacy as a logic model that can lead to better health through behavior change. The steps closely align with what teachers often address in literacy programs anyway: "The five-step logic model of the Calgary Charter on Health Literacy proposes that people can (and can be helped to) use their skills to (1) find, (2) understand, (3) evaluate, (4) communicate, and (5) use information to make informed decisions. That logic model can be used to design effective programs, critically evaluate, and inform both sides of the health literacy equation—the supply from individuals and the demand from health systems and professionals."

This presents an exciting challenge to adult literacy programs to incorporate health literacy education into their offerings. 

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