Definitions of health literacy: a review of the literature

Objective (s): Health literacy is a relatively new emerging concept in public health. It is also a new area for research with links to communication. It has been suggested that health literacy incorporates all of the major psychological, social, and environmental constructs that influence individual health choices. It has been suggested that poor health literacy poses a major barrier to public’s health and might represent a major cost to health care system. The aim of this study was to examine what is health literacy. A review was undertaken of all the full publications in the English and Persian language biomedical journals between 1993 and 2012. The search was restricted to ‘health literacy’ that appeared in the titles/abstracts of the publications. In addition, a manual search was performed to include additional papers of potential interest. In all 1788 citations were identified. After screening, 1265 duplicate citations were excluded. The remaining 523 citations were further examined and 438 citations were found irrelevant. Finally the full texts of 85 papers were assessed. Of these 42 papers were found to be relevant and were included in this review. The findings indicated that variations exist in defining health literacy and each definition contained some aspects of health literacy. We identified that a comprehensive definition of health literacy might include the following constructs: ability to read, ability and skills to access, understand, and appraise health information, make decisions, and practice in order to maintain or improve health. An agreed definition of health literacy is needed. An authoritative body might propose such a definition.