The causal pathways linking health literacy to health outcomes

Am J Health Behav. Sep-Oct 2007;31 Suppl 1:S19-26. doi: 10.5555/ajhb.2007.31.supp.S19.


Objective: To provide an evidence-based review of plausible causal pathways that could best explain well-established associations between limited health literacy and health outcomes.

Methods: Through analysis of current findings in medical and public health literature on health literacy we derived a conceptual causal model.

Results: Health literacy should be viewed as both a patient and a system phenomenon. Three distinct points along a continuum of health care are suggested to be influenced by health literacy: (1) access and utilization of health care, (2) patient-provider relationship, and (3) self-care.

Conclusions: The conceptual model organizes what has been learned to date and underscores promising areas of future inquiry and intervention.

MeSH terms

  • Educational Status*
  • Health Knowledge, Attitudes, Practice*
  • Health Promotion
  • Health Services Accessibility / statistics & numerical data
  • Health Status*
  • Humans
  • Professional-Patient Relations
  • Self Care