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Article
March 20, 1996

Inadequate Functional Health Literacy-Reply

Author Affiliations

Emory University School of Medicine
Georgia State University Atlanta

JAMA. 1996;275(11):840. doi:10.1001/jama.1996.03530350022028
Abstract

In Reply.  —Drs Gottesman and Kelly raise an interesting question about the root causes of low literacy. We agree that some people who have low literacy skills may have specific learning disabilities (eg, dyslexia) that prevented them from learning to read. However, we believe the vast majority of the problem stems from lack of access to education or poor-quality education during critical developmental periods. The higher prevalence of low literacy among older adults and Spanish-speaking patients, many of whom were unable to go to school or attended schools with very poor facilities, supports this explanation and argues against learning disabilities as the dominant cause. Labeling low literacy as a learning disability is also extremely dangerous because many children from racial and ethnic minorities in the United States have been cast aside into "handicapped" classes because their language abilities were behind their peers.Nevertheless, we agree that many patients with low

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