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Health literacy and the 'inverse information law'.

Low literacy frequently leads to disadvantaged socioeconomic circumstances, and adverse effects on health that are independent of other risks. More directly, individuals and populations with lower literacy are less likely to be responsive to established approaches to health education, less likely to use disease prevention services, and less likely to be successful in the self-management of long-term conditions.1 A recent King’s Fund study exploring the impact of health promotion campaigns in England showed little effect on health behaviours among people with few or no qualifications.2

These findings have generated considerable international interest in the relationship between literacy and health. This interest is observable in research into the measurement of health-related literacy, examination of the relationship between low literacy and a range of health conditions, and testing of interventions designed to mitigate the effects of low literacy.1,3,4

Much of this growing body of research has emanated from the US, where the term ‘health literacy’ is commonly used to describe the set of individual literacy capacities that act as a mediating factor in health and clinical decision making.5 Poor literacy skills are viewed as a risk to be managed in clinical care. Doctors have a key role in managing this risk; a study published in the BJGP shows that, for older patients with low health literacy, those with a better relationship with their doctor feel they have a higher level of involvement in …