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Then, the concepts of obtaining, processing/understanding, and using information serve as a working framework for discussing both the challenges of low health literacy and strategies to address low health literacy. Only 12 percent of Americans have an adequate level of health literacy, resulting in an additional $73 billion annually in healthcare expenditures (National Academy on an Aging Society, 1999; White, 2008).

Some insurance companies, clinics, and other health organizations will mail text-based information to their publics or provide on-site “libraries” of health information.

Unfortunately, these efforts at promoting health information are inconsistent and highly dependent upon level of public funding and geographic location, with the poorer and more rural populations at a greater disadvantage.

To make matters worse, many persons low in health literacy often do not see the same provider each time they seek care, making it even more challenging for providers to develop and maintain good relationships.

Additionally, time is often in short supply during medical interviews and examinations, as pressures continue to mount for healthcare providers to increase the number of patients they see each day.

Despite the increase in attention to this concept, a consensus amongst researchers as to a definition of the term has yet to be reached; many definitions of health literacy have been developed, each providing a slightly different perspective.

Some of the most widely accepted definitions of health literacy have been developed by the World Health Organization (WHO), the American Medical Association (AMA), and the Institute of Medicine (IOM).

Speaking with a knowledgeable healthcare provider offers (among other advantages) the opportunity for interactivity between patients and healthcare professionals; yet this method of information delivery poses many challenges related to health literacy (Schillinger, Bindman, Wang, Stewart, & Piette, 2004).

One of the most difficult challenges healthcare providers may need to overcome when speaking with persons having low health literacy is gaining their trust.

Health literacy is a dynamic process that involves both the patient and the provider (Paasche-Orlow & Wolf, 2007).

Inadequate health literacy is more prevalent among vulnerable populations, such as the elderly, minorities, persons with lower education, and persons with chronic disease (De Walt et al.).

The term health literacy was introduced in 1974 in a paper calling for minimum health education standards for all grade-school levels in the United States (US) (National Library of Medicine, 2000).