Functional health literacy: an issue in African-American and other ethnic and racial communities

J Natl Black Nurses Assoc. 2004 Jul;15(1):1-4.


The purpose of this study was two-fold: to identify and assess the functional health literacy level among a group of African-American adults and to determine the feasibility of conducting a functional health literacy assessment in community-based settings, primary, and acute care settings. This was an exploratory descriptive study done to ascertain the degree of health literacy among a sample of respondents from vulnerable populations including African-Americans and Hispanics. The total sample was comprised of 190 (N = 190) men and women in Los Angeles and New York. This included a sample of 81 (n = 81) African-American participants and 16 (n = 16) Hispanic participants. The average age of the total sample was 43 years of age, and 47% of the total sample was male, while 53% were female. The average age of the African-American sample was 41 years Conversely, 53% of the African-American sample was male, while 47% of the sample was female. The Modified Test of Functional Health Literacy in Adults (TOFHLA) survey instrument, developed by Williams and Colleagues (1995), was administered to participants to assess health literacy. The TOFHLA consisted of a Reading Comprehension component that contained 39 multiple-choice questions. Findings from this study suggest that patients who have marginal or inadequate functional health literacy will have difficulty reading, understanding, and interpreting most written health texts and instructions In addition, patients with marginal or inadequatefunctional health literacy scores are more likely to misunderstand directions for health care. Consequently, these patients are also more likely to take medications incorrectly and more likely to fail to follow a prescribed diet or treatment regimen.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Black or African American*
  • Educational Status*
  • Female
  • Hispanic or Latino
  • Humans
  • Los Angeles
  • Male
  • Medication Errors / prevention & control*
  • New York City
  • Patient Compliance*
  • Reading*