A health literacy colleague recently posted about the difference between literacy and health literacy. And while I appreciate the post (my practice includes both), I believe it reduced the perceived importance of literacy in how the two are connected.
Now don’t get me wrong, I wholeheartedly understand the need to distinguish between literacy and health literacy. However, that post’s perspective on literacy prompted me to reflect on some differences and realities that, in my view, deserve closer examination and a more modern application—insights I believe are worth sharing. So, here goes.
Literacy today is no longer seen as a one-dimensional ability to read and write. Rather, it can be defined as a foundational understanding across multiple domains. More, it is the ability to understand, create, and use information across contexts to make informed decisions, solve problems, and participate fully in society. It includes numeracy and digital skills, evolves throughout life, and is a fundamental human right that drives social and economic progress, (UNESCO, 2004).
Using “literacy” in this broader sense only begins to acknowledge the complexity and depth of the term that can be decoded to represents a skill set (ability to read, write, communicate), a process (developed through continuous practice), a social practice (shaped by contexts), a construct (measurable for research), and a means for empowerment and participation (purpose of literacy).
In the realm of health literacy, which is a more specific subset, we typically recognize four domains: 1.) fundamental literacy, 2.) civic literacy, 3.) scientific literacy, and 4.) cultural literacy, (Rudd et al., 2005). The fact that health literacy is constructed upon these pillars demonstrates both the complexity of the field and the robust, multidimensional nature of literacy itself as multiple literacies are foundation for territories as broad as civics, science, and culture.
In short, while I support the point that health literacy’s purview focuses and reaches beyond early readers’ reading levels, the reason for this is to ensure that high-level concepts are grounded in accessible, foundational understanding for the masses. Accessibility should not be bypassed or overlooked for the sake of appearing complex when the elegance of clear, straightforward approaches often proves more efficient and impactful. Consider in this regard the symbiotic relationship of plain language and health literacy practice.
More importantly, those whose lives touch and intersect health literacy spaces are of all ages and reading levels. It is also worth noting that literacy exists along a continuum, on which individuals may possess varying levels of literacy about the same subject, from low to high. This further bolsters the notion that literacy is not a basic or primitive notion, but rather that it is layered and dynamic.
Finally, literacy is inextricable from education, which is why in the USA, together and apart from health literacy, they are identified as social determinants of health. Therefore, to downplay the importance of literacy undermines the shared goal we all have: Advancing health, literacy, and health literacy for All.
–Valerie L. Williams-Sanchez, PhD
References:
- International Literacy Association. (n.d.). Children's Rights to Read. literacyworldwide.org.
- Rudd, R. E., Moeykens, B. A., & Colton, T. C. (1999). Health and literacy: A review of medical and public health literature. In J. Comings, B. Garner, & C. Smith (Eds.), Annual review of adult learning and literacy: Vol. 1 (pp. 158–199). San Francisco, CA: Jossey-Bass.
- UNESCO. (2004). The plurality of literacy and its implications for policies and programmes. UNESCO Education Sector Position Paper. Paris, France: United Nations Educational, Scientific and Cultural Organization.
- U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (n.d.). Language and literacy [Literature summary]. Healthy People 2030. Retrieved July 1, 2025, from https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/language-and-literacy
- World Literacy Summit. (2025, April). Proceedings of the 2025 World Literacy Summit and the Oxford Declaration. Oxford, United Kingdom: World Literacy Summit.
