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Health Literacy and Older Adult Populations

Health Literacy and Older Adult Populations

Johnette Peyton, MS, MPH, CHES and Devon Lapoint

Are you sure that the health information you are providing is written at the appropriate level for your target audience?

Approximately 36% of adults in the United States have basic or below basic health literacy[i]. Health Literacy is defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (pp. 11-20) according to the U.S. Department of Health and Human Services[ii].

Results from the 2003 National Assessment of Adult Literacy[iii], indicate that adults ages 50 and over have the lowest average health literacy score among adults ages 16 and over. Studies have shown that those with low health literacy have a higher risk of death and visit the emergency room more frequently.   Low-income, minority and immigrant older adult populations are especially at risk.

Health literacy and health communication are complementary concepts. When working with older adults who may have low health literacy, good health communication can increase patient understanding.

Oral Communication

The Language of Understanding[iv]

  • Create a “shame-free” environment for learning. Use a gentle and supportive approach, and be non-judgmental about people’s reading difficulties. Let the older adult know that many people have difficulty learning new information.
  • Ask about a person’s learning preferences, and then adapt your teaching style to meet that person’s needs. For example, you can read materials aloud with an older adult patient and then highlight key points to personalize this information.
  • Encourage the older adult to invite family or friends into the teaching sessions. Not only does this establish a warm and supportive environment, but it also educates those who later can reinforce and clarify information.
  • Verify understanding by finding out what an older adult understands and what he or she does not. Find out what the older adult thinks is happening, and what they still need to learn

Written Materials

A Plain Language Review[v]

o   Engage the reader

  • Consider what the reader needs to know. Organize content to answer the reader’s questions
  • Write for the appropriate reading level

o   Write Clearly

  • Use common, everyday words whenever possible
  • Avoid using undefined technical terms
  • Use short sentences
  • Include a lot of white space in print materials
  • Use positive rather than negative words
  • Use active voice


Health Literacy Universal Precautions Toolkit

Elements of Plain Language

Senior Health Literacy Webinar: Becoming a Health Literate Organization

[i] National Center for Education Statistics. The Health Literacy of American’s Adults: Results from the 2003 National Assessment of Adult Literacy. http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483

[ii] U.S. Department of Health and Human Services. Healthy People 2010. NLM Pub No. CBM 2000-1

[iii] American Council on Education. The Health Literacy of U.S. Adults Across the GED Credential Recipients, High School Graduates, and Non-High School Graduates. http://www.gedtestingservice.com/uploads/files/111744734ba9a7cd559b409f7a9c3e21.pdf

[iv] Jesse Justice. The Language of Understanding: Effective Communication Strategies for Health Care Professionals Working with Older Adults. http://www.healthcommunications.org/resources/seubert_research_paper.pdf

[v] National Institutes of Health. Plain Language: Getting Started or Brushing Up. http://www.nih.gov/clearcommunication/plainlanguage/gettingstarted/index.htm