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Introduction¹

The field of health literacy has evolved from one focused on individuals to one that recognizes that health literacy is multidimensional. Health literacy, explained Bernard Rosof, professor of medicine at the Zucker School of Medicine at Hofstra/Northwell and chief executive officer of the Quality HealthCare Advisory Group, includes both system demands and system complexities, as well as individual skills and abilities. While communicating in a health literate manner is important for everyone, it is particularly important when communicating with those with limited health literacy who also experience more serious medication errors, higher rates of hospitalization and use of the emergency room, poor health outcomes, and increased mortality. “Over the past decade, research has shown that health literacy interventions can significantly impact various areas including health care costs, outcomes, and health disparities,” said Rosof in his introductory remarks to the workshop. He continued:

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¹ This section is based on the presentation by Bernard M. Rosof, chief executive officer, Quality HealthCare Advisory Group, LLC, and professor of medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, and his statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.

To understand the extent to which health literacy has been shown to be effective at contributing to the Quadruple Aim of improving the health of communities, providing better care, providing affordable care, and improving the experience of the health care team, the Roundtable on Health Literacy established an ad hoc committee to plan and conduct a public workshop on building the case for health literacy (see Box 1-1).² The roundtable also commissioned a paper that would identify and describe peer-reviewed evidence of the effect of health literacy in a variety of areas.

ORGANIZATION OF THE PROCEEDINGS

An independent planning committee organized this workshop in accordance with the procedures of the National Academies of Sciences, Engineering, and Medicine. (See Appendix A for the agenda.) The planning committee’s members were Susan Bockrath, Lori Hall, Stanton Hudson, Laurie Myers, Laura Noonan, Audrey Riffenburgh, Bernard Rosof, Steven Rush, and Michael Villaire. This publication summarizes the workshop’s presentations and discussions, and it highlights important lessons about the role of health literacy in meeting the Quadruple Aim, case studies of organizations that have adopted health literacy, and discussions among the different stakeholders involved in making the case for health literacy. Chapter 2 provides a patient’s perspective on the need for health literacy and Chapter 3 recounts

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² The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop was prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.

the discussion on the commissioned paper. Chapter 4 discusses why health literacy is important and Chapter 5 provides examples of how different organizations adopt health literacy. Chapter 6 recaps a moderated discussion on the future of the field of health literacy and Chapter 7 summarizes the roundtable members’ reflections on the day’s discussions.

In accordance with the policies of the National Academies of Sciences, Engineering, and Medicine, the workshop did not attempt to establish any conclusions or recommendations about needs and future directions, focusing instead on issues identified by the speakers and workshop participants.

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