Measuring Health Literacy
Health literacy can be measured in a range of ways. The choice and use of a specific measurement will vary according to context and purpose. These range from a simple and quick tool to assess individual patient needs in clinical practice through to more complex and sophisticated measures that might be used in population research. We recommend some of the more commonly used and practical measures below and the Boston University Health Literacy Tool Shed, which provides a comprehensive repository of different measures from around the world.
Health Literacy Toolshed, Boston University
Searchable database of health literacy measurement tools.
Screening questions for limited health literacy, Chew et al., 2008
A single item, self-report question intended to identify adults in need of help with printed health material. This measure is easy to use and administer, and is suitable for clinical practice and research. However, it may not identify all people with lower literacy. (Only accessible with a University of Sydney Library login)
Newest Vital Sign (NVS), Pfizer
The Newest Vital Sign is a widely-used measure of health literacy skills. It is based on a nutrition label from an ice-cream container. Patients are given the label and asked to answer 6 questions about it. The NVS takes approximately 3 minutes to administer. This measure performs moderately well in identifying people with limited health literacy.
Health Literacy Questionnaire (HLQ)
The HLQ is a self-report measure of health literacy that has been designed to describe the health literacy strengths and limitations of individuals and populations based on nine health literacy domains. This measure is being used by the Australian Bureau of Statistics to measure health literacy in the Australian population. The HLQ can take up to 45 minutes to complete. A licence is required to use this measure.
BERKMAN, N. D., SHERIDAN, S. L., DONAHUE, K. E., HALPERN, D. J., & CROTTY, K. (2011). Low Health Literacy and Health Outcomes: An Updated Systematic Review. Annals of Internal Medicine, 155(2), 97–107. https://doi.org/10.7326/0003-4819-155-2-201107190-00005Berkman systematic review:
ABS data/surveys
• Australian Bureau of Statistics
Australian and international policies:
•2020–25 National Health Reform Agreement (NHRA)
• United Nations Department of Economic and Social Affairs Sustainable Development
•Centers for Disease Control and Prevention (CDC)
•Australian Commission on Safety and Quality in Health Care