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Comment & Response
August 2014

Improving Evidence-Based Practices Through Health Literacy

Author Affiliations
  • 1The Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 2Harvard School of Public Health, Boston, Massachusetts
JAMA Intern Med. 2014;174(8):1413. doi:10.1001/jamainternmed.2014.847

To the Editor The research findings by Wegwarth and Gigerenzer1 is a sober reminder of the need for better communication between clinicians and patients about the appropriateness of testing and interpretation of results. The inquiries of health literacy have demonstrated poor health outcome when there is a mismatch between patient skills required for the interpretation of health information and the demands clinicians and the health care system imposed on patients.2 When demands exceed the requisite skills, patients may feel overwhelmed and retreat into silence or stop actively participating in their own care. Health literacy is not limited to just the fundamental skills of reading, writing, speaking, and numeracy and simplifying the health information, although these can be part of it. It is a continuum of multidimensional skill sets of competencies acquired over a lifetime that allows an individual to access, participate in, and make informed decisions that directly and indirectly affect health. Studies have shown that even those who have high fundamental literacy skills have poor health literacy and that up to half of US adults are not able to effectively use written material to accomplish health-related tasks.3

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