Health literacy: the sixth vital sign

Purpose: The purpose of this project was to describe the concept of health literacy, and to assess health literacy levels in diabetic patients receiving care in primary care settings.

Data sources: Health literacy was measured by the Newest Vital Sign (NVS), an assessment tool that was developed for use in primary care settings. The sample consisted of 54 participants of whom 22% were Caucasian, 43% Black, and 35% Latino/Latina. Health literacy scores ranged from 0-6, with a mean of 2.87. Nearly 2/3 of the participants obtained scores of 3 or less, indicating a strong possibility of limited literacy. Significant correlations were obtained between health literacy and educational level, and between health literacy and ethnicity/race.

Conclusions: Limited health literacy is so common that health literacy assessment needs to be considered in all clinical practice settings. Health literacy is considered the sixth vital sign--along with temperature, pulse, respiration, blood pressure, and pain level.

Implications for practice: The NVS takes about three minutes to administer and the assessment is easily accomplished during the initial visit for each patient. Healthcare providers will then be aware of the health literacy level of each patient and base their communication appropriately.