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Slides 11–18

Health Literacy

Slide Number Title and Content

Percentage of Adults in Each Literacy Level: 2003

Narrative:  This slide shows how the health literacy levels compare to the literacy levels for the prose, document and quantitative scales.  The percent of adults in the Below Basic health literacy level is more comparable to what we see for the prose and document scales than for the quantitative scale.  A majority of adults (53 percent) had Intermediate health literacy.  An additional 12 percent of adults had Proficient health literacy.  Among the remaining adults, 22 percent had Basic health literacy and 14 percent had Below Basic health literacy.

Percentage of Adults With Selected Characteristics in the Below Basic Prose Literacy Level

  Below Basic Basic Intermediate Proficient
Prose 50 33 15 2
Document 51 29 18 1
Quantitative 61 26 11 2

Narrative:  This slide focuses on the adults in the Below Basic health literacy category (which constituted 14 percent of adults). About half were Below Basic in prose and document literacy, and over 60 percent were at Below Basic on the quantitative scale. Approximately one-fourth to one third or more had Basic literacy. And one-sixth of those who scored Below Basic in health literacy were at or above the Intermediate level in prose (15%) and document literacy (18%), and less for quantitative literacy (11%). Thus, consistent with the less than perfect correlation between health literacy and prose, document, and quantitative scales, these data suggest that some unique skills are associated with health literacy.


Percentage of Adults in the Below Basic Health Literacy NAAL Population: 2003

Characteristic Percent in Below Basic population Percent in total population
Did not graduate from high school 51 15
Did not speak English before starting school 39 13
Adults reporting poor health 10 4
Hispanic adults 35 12
Age 65+ 31 15
No medical insurance 36 18
Did not obtain health information over the Internet1 80 43
Black adults 19 12
One or more disabilities2 48 30
1The "Did not obtain health information over the Internet" category does not include prison inmates because they do not have access to the Internet.
2Disabilities include vision, hearing, learning disability, and other health problems. 
SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics, 2003 National Assessment of Adult Literacy (NAAL).

Narrative:  This slide shows how the adults with Below Basic health literacy are different from adults in the population as a whole. The first column lists the percentage each group represents in the health literacy Below Basic level. For example, 51 percent of the adults in the Below Basic level did not graduate from high school. The second column shows each group’s representation in the general population. Adults who did not graduate from high school are 15 percent of the entire adult population. So, these adults are over-represented in the Below Basic category of health literacy.


Percentage of Adults in Each Health Literacy Level, by Educational Attainment: 2003

Narrative:  Starting with adults who had graduated from high school, average health literacy increased with each higher level of educational attainment. Among adults who did not complete high school, 49 percent had Below Basic health literacy, compared with 15 percent of adults who ended their education with a high school diploma. On the other hand, not all those who graduated from college had intermediate or proficient health literacy skills. Among those with a four-year college degree, for example, 13 percent had Basic or Below Basic health literacy skills.


Percentage of Adults in Each Health Literacy Level, by Languages Spoken Before Starting School: 2003

Narrative:  Adults who spoke only English before starting school had higher health literacy scores than did adults who spoke other languages alone or other languages and English. Adults who spoke only Spanish before starting school had the lowest mean health literacy score.


Percentage of Adults in Each Health Literacy Level, by Self-Assessment of Overall Health: 2003

Narrative:  About 76 percent of adults, (which includes 57% in the Intermediate and 19% in Proficient) who reported their overall health was excellent had Intermediate or Proficient health literacy. In contrast, 69 percent (which includes 42% Below Basic and 27% Basic) of adults who reported their health was poor, had Basic or Below Basic health literacy. These data show that those who are most in need of health literacy are the ones with the poorest reported health.


Upcoming Reports

  Expected Release
  • Literacy in Everyday Life: A report of literacy in family, workplace, and community
Fall 06
  • Literacy Behind Bars: Report on a nationally representative sample of adult inmates in state and federal prisons.
Winter 07
  • Basic Reading Skills and the Literacy of America's Least Literate Adults: Report on the oral reading fluency and performance of a supplemental sample of the least literate adults.
Spring 07


NAAL Web-Site:

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