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Health Literacy

Health literacy is “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions”.1 It informs or limits an individual’s ability to search for and use health information, adopt healthy behaviors, follow prescribed treatment plans, and act on important public health alerts. Limited health literacy is associated with worse health outcomes and higher costs2 and in the collegiate population can also lead to impaired student success. Health literacy is not only about individuals’ skills; in the United States, health literacy reflects the efforts of health systems and professionals to make health information and services understandable and actionable. Interventions across multiple sectors need to focus on improving individual skills and making health service, education, and information systems more health literate.2


Key Facts

  • Nearly 9 of 10 adults have difficulty using the everyday health information that is routinely available in our healthcare facilities, retail outlets, media, and communities.1,3,4
  • The average annual healthcare costs of those with low health literacy levels are 4 times greater than that of the general population.5,6,7
  • Poor health literacy costs the U.S. healthcare system $30-$73 billion annually.5,6
  • 90 million Americans lack the skills needed to understand and act on health information.9
  • Individuals with low health literacy are less likely to participate actively in healthcare decision making and more likely to struggle with health management tasks and to face significant challenges navigating the health system. 9
  • Approximately 9 of 10 U.S. adults (88%) cannot calculate an employee's share of health insurance costs using a table based on income and family size.3
  • Health literacy is a better predictor of one’s health status than: age, income, employment, ethnicity, or education level.10,11
  • In 2006, 3 million Americans reported being seriously harmed or knowing someone who has been seriously harmed by following health advice or information found online.1

Suggestions for Parents & Families

This page is intended to be a resource containing suggestions for what you can do to increase your students’ capacity to make appropriate healthcare decisions.

Be knowledgeable about NYU’s health and wellness services for students and able to refer them to the appropriate resources when necessary.The Student Health Center is comprised of a comprehensive set of medical, counseling, and ancillary services. These include but are not limited to the NYU Wellness Exchange with 24/7 crisis response, Physical Therapy, Radiology, Allergy and Travel Medicine, Psychiatry, Specialty Services, Optometry, Pharmacy Services, Health Promotion, and the Moses Center for Students with Disabilities. Whether enrolled in an NYU-sponsored Student Health Insurance plan or maintaining alternate health insurance coverage, the Student Health Center offers routine and walk-in Primary Care and Women's Health Services at either no cost or very reduced cost to all matriculated NYU students. In addition, Wellness, Short-term Counseling (talk therapy) and Crisis services are free of charge. Learn more about specific Student Health Center services, hours of operation, and how students can make an appointment at the NYU Student Health Center website.

Provide your student with a copy of his or her health history. Be sure to include a list of completed vaccinations, allergies, current medications, family history and risk factors, and any other important health information.

Review insurance information with your student. Regardless of which insurance plan your student has, please ensure that your student has an insurance card and other relevant insurance information. Review the co-pay policy together. In planning for your student’s overall health and wellness, be sure his or her insurance plan provides for mental health as well as general health benefits in New York City that meets the University's criteria.

Empower your student to be prepared for and ask questions during visits with a health care provider. Encourage your student to inquire about a diagnosis, treatment plan, and any prescribed medications.  For resources to help your student prepare for a visit with a health or mental health care provider, visit the National Patient Safety Foundation’s Checklist for Getting the Right Diagnosis.

Refer your student to credible sources of health information. Health information is critically important for empowering individuals to be active participants in personal health actions and decisions.39 The Internet is the primary source of information for the majority of NYU students,40-42 yet students can and do obtain health information from a variety of sources including healthcare professionals, magazines, brochures, family, friends, news/media, and peers, among other sources.41 Students often lack the skills to locate and evaluate effectively the information for credibility and quality, analyze the risks and benefits, and use high quality health information; therefore, they can suffer adverse consequences from using unreliable information.39,43,44 Remind students to be skeptical of online health sources and encourage them to only use credible sources such as: The Student Health Center’s Health Promotion Office, a health care provider, the NYU Student Health Center website, Centers for Disease Control and Prevention (CDC), HealthFinder.gov, Medline Plus, or Mayo Clinic.


health literacy indicators


a) Provision of health education by NYU Student Health Center during patient visits

  • Data Source: Customer Satisfaction Survey #20
  • Survey Question: I received information during my visit that I will use to improve my health
  • Definition:

b) Students who incurred unexpected charges after receiving medical or mental services

  • Data Source: ACHA – custom question
  • Survey Question: True or False: In the last 12 months, when I received medical or mental health services (whether at the NYU Student Health Center or elsewhere), the charges I incurred were always what I expected.
  • Definition: of those who received services, proportion who responded “false” (does not includes N/A in denominator)

c)  Confused by online health information

  •  Data Source: ACHA – custom question
  • Survey Question: At any point in your last search for health information online did you feel any of the following things? (Select ALL that apply)
  • Definition: proportion who endorsed “Confused by the information you found online”

  1. Nielsen-Bohlman, L., Panzer, A.M., & Kindig, D.A. (2004). Health Literacy: A Prescription to End Confusion. Washington, DC: Committee on Health Literacy. Board on Neuroscience and Behavioral Health. Institute of Medicine of the National Academies.
  2.  U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. (2010). National Action Plan to Improve Health Literacy. Retrieved 7/15/2011, from: http://www.health.gov/communication/hlactionplan/pdf/Health_Literacy_Action_Plan.pdf
  3. Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006-483). Washington, DC: U.S. Department of Education.
  4.  Rudd, R. E., Anderson, J. E., Oppenheimer, S., & Nath, C., (2007). Health literacy: An update of public health and medical literature. In J. P. Comings, B. Garner, & C. Smith. (Eds.), Review of adult learning and literacy, 7, 175–204. Mahwah, NJ: Lawrence Erlbaum Associates.
  5. Friedland, R.B, & Summer, L. (1999). Demography Is Not Destiny. Washington, DC: National Academy on an Aging Society.
  6. Friedland, R.B. (1998). Life expectancy in the future: A summary of a discussion among experts. North American Actuarial Journal, 2(4), 1-14.
  7. Weiss, B.D. (1999). 20 Common Problems in Primary Care. New York: McGraw Hill, 468-481.
  8. Center for Health Care Strategies, Inc. (2005). Health Literacy Fact Sheet. The Commonwealth Fund and Pfizer Inc. Retrieved 10/25/11, from http://www.chcs.org/usr_doc/Health_Literacy_Fact_Sheets.pdf
  9. Martin, L.T., & Parker, R.M. (2011). Insurance expansion and health literacy. Journal of the American Medical Association. Published online August 9, 2011. Retrieved 10/25/11, from http://jama.amaassn.org/content/early/2011/08/05/jama.2011.1212.full
  10. American Medical Association. (2004). Health Literacy. AMA-MSS Community Service Committee. Retrieved 10/25/11, from http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/community-service/health-literacy.page
  11. Weiss, B.D. (2003). Health Literacy: A Manual for Clinicians. American Medical Association/American Medical Association Foundation, 7.
  12. Fox, S. (2006). Online Health Search 2006. Washington, DC: Pew Internet and American Life Project.
  13. Bernstein, A.B., Hing, E., Moss, A.J., Allen, K.F., Siller, A.B., & Tiggle, R.B. (2003). Health care in America: Trends in utilization. Hyattsville, Maryland: National Center for Health Statistics.
  14. Pawlak, R. (2005). Economic considerations of health literacy. Nursing Economics, 23, 170–180.
  15. Vitt, L.A., Siegenthaler, J.K., Siegenthaler, L., Lyter, D.M., & Kent, J. (2002). Consumer Health Care Finance and Education: Matters of Values (EBRI Issue Brief 241). Institute for Socio-Financial Studies, Employee Benefit Research Institute.
  16. Finkelstein, A., Taubman, S., Wright B, Bernstein M, Gruber J, Newhouse JP, & Allen, H., Baicker, K. (2011). The Oregon Health Insurance Experiment: Evidence from the First Year (NBER Working Paper No 17190). The Oregon Health Study Group.
  17. Student Health Insurance Services. (2011). Guide to Student Health Insurance and Healthcare at New York University, 2011-2012. New York University. Retrieved 10/25/11, from http://www.nyu.edu/shc/about/insurance.html
  18. Cunningham, P.J., Denk, C., & Sinclair, M. (2001). Do consumers know how their health plan works? Consumers tend to overestimate plan restrictions, especially regarding access to medical specialists. Health Affairs, 20(2), 159-166.
  19. Hibbard, J.H., & Jewett, J.J. (1997). Will quality report cards help consumers? Health Affairs, 16(3), 218-28.
  20. Isaacs, S. (1996). Consumers’ information needs: Results of a national survey. Health Affairs, 15(4), 31-41.
  21. Korcyk, S., & Witte, H. (2000). C.I.G. to managed health care. Upper Saddle River: NJ: Prentice Hall.
  22. Healthy People 2020. Health Communication and Information. Washington, DC: U.S. Department of Health and Human Services.
  23. Finkel, M.L. (1997). Evaluate and communicate health care benefits. Employee Benefits Journal, 22(4), 29-34.
  24. Jerussi, M, Savan, J. (2000). Educating employees on defined contribution health care: The time is eight for an employee-empowering approach. Benefits Quarterly, 16(4), 63-68.
  25. Emery, J, Cather, C. (2000.) Finally. Employers provide a focus to help health plans fashion full-scale e-strategies. Health Plan Advisor, 1-7.
  26. Goff, V. (2001). Consumer health care decision support: State of the art. Executive Brief. Washington, DC: National Health Care Purchasing Institute.
  27. Detmer, D., Bloomrosen, M., Raymond, B., & Tang, P. (2008). Integrated personal health records: Transformative tools for consumer-centric care. BMC Medical Informatics and Decision Making, 8, 45.
  28. New York University. (2010). Wellness expo evaluation.
  29. American College Health Association. American College Health Association - National College Health Assessment II: New York University Executive Summary Spring 2009. (2009). Hanover, MD: Author.
  30. American College Health Association. (2011). American College Health Association - National College Health Assessment II: New York University Executive Summary Spring 2011. Hanover, MD: Author.
  31. Rieh, S.Y., & Hilligoss, B. (2008). College students’ credibility judgments in the information-seeking process. Digital Media, Youth, and Credibility. The John D. and Catherine T. MacArthur Foundation Series on Digital Media and Learning. Cambridge, MA: The MIT Press, 49–72.
  32. Banas, J. (2008). A tailored approach to identifying and addressing college students’ online health information literacy. American Journal of Health Education, 39, 228–236.
  33. Neuhauser, L. (2001). Participatory Design for Better Interactive Health Communication: A Statewide Model in the U.S.A. The Electronic Journal of Communication. 11(3-4).
  34. U.S. Department of Health and Human Services. National Partnership for Action to End Health Disparities. Office of Minority Health. (2011, April). National stakeholder strategy for achieving health equity. Washington, DC: Author.
  35. Kimery, K.M., & Rinehart, S.M. (1998). Markets and constituencies: An alternative view of the marketing concept. Journal of Business Research, 43 (3), 117-24.
  36. U.S. Agency for International Development. (2002). Behavior change communication for HIV/AIDS: A strategic framework. Family Health International Institute for HIV/AIDS. Implementing Prevention and Care (IMPACT) Project.
  37. Centers for Disease Control and Prevention. (2009). What we know about health literacy. Health Communication and Marketing. National Center for Health Marketing. Washington, DC: U.S. Department of Health and Human Services.
  38. Adams, R.J., Stocks, N.P., Wilson, D.H., & Hill, C.L. (2009). Health literacy-a new concept for general practice. Australian Family Physician. 38 (3), 144-147.
  39. U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. (2010). National Action Plan to Improve Health Literacy. Retrieved 7/15/2011, from: http://www.health.gov/communication/hlactionplan/pdf/Health_Literacy_Action_Plan.pdf
  40. New York University. (2010). Wellness expo evaluation.
  41. American College Health Association. American College Health Association - National College Health Assessment II: New York University Executive Summary Spring 2009. (2009). Hanover, MD: Author.
  42. American College Health Association. (2011). American College Health Association - National College Health Assessment II: New York University Executive Summary Spring 2011. Hanover, MD: Author.
  43. Rieh, S.Y., & Hilligoss, B. (2008). College students’ credibility judgments in the information-seeking process. Digital Media, Youth, and Credibility. The John D. and Catherine T. MacArthur Foundation Series on Digital Media and Learning. Cambridge, MA: The MIT Press, 49–72.
  44. Banas, J. (2008). A tailored approach to identifying and addressing college students’ online health information literacy. American Journal of Health Education, 39, 228–236.


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