Attributes of a Health Literate Organization

By Cindy Brach, Benard Dreyer, Paul Schyve, Lyla M. Hernandez, Cynthia Baur, Andrew J. Lemerise, Ruth Parker
January 27, 2012 | Discussion Paper

What Is a Health Literate Organization?

This paper describes ten attributes of a health literate organization, that is, an organization that makes it easier for people to navigate, understand, and use information and services to take care of their health. (See Table 1.) The health care system is very complex. Most people in the United States have difficulty understanding and using currently available health information and health services. This means there is an imbalance between the skills of people and the demands of the health care system.


Why Now?

Addressing health literacy is critical to transforming health care quality. Goals for safe, patient-centered, and equitable care cannot be achieved if consumers cannot access services or make informed health care decisions. These attributes are offered as guides for achieving the vision of being a health literate organization. The attributes are based on real world evidence and best practices. But it is not expected that any organization would have already achieved all 10 attributes.


How Should Organizations Use These Attributes?

These attributes are guidelines for health care organizations that seek to ensure that everyone gets the greatest benefit possible from health care information and services. There are many paths to becoming a health literate organization. Individual health care organizations will probably choose different strategies and should be encouraged to test how well their strategies work and to share the results of their efforts with others.


Who Should Use These Attributes?

  • Providers and small groups/teams that deliver health care, e.g., clinicians, dentists, administrative staff, group practices, clinics, inpatients units, subspecialty teams.
  • Health care organizations that house providers and groups/teams that deliver health care, e.g., hospitals, community health centers, pharmacy practices, and integrated systems.
  • Payors and health plans, e.g., health maintenance organizations, insurance carriers, employee-based plans, the Veterans Administration, and the Centers for Medicare and Medicaid Services.


Table 1 | Attributes of a Health Literate Organization

Note: This paper draws from work by Dean Schillinger and Debra Keller of the University of California, San Francisco, which was commissioned by the Roundtable on Health Literacy and presented at a workshop on November 16, 2012.


  1. Abrams, M. A., and B. P. Dreyer, eds. 2008. Plain language pediatrics: Health literacy strategies and communication resources for common pediatric topics. Elk Grove, IL: American Academy of Pediatrics.
  2. AHRQ (Agency for Healthcare Research and Quality). 2010. Health literacy universal precautions toolkit. (accessed January 9, 2012).
  3. AHRQ. 2011a. AHRQ pharmacy health literacy center. (accessed January 9, 2012).
  4. AHRQ. 2011b. CAHPS item set for addressing health literacy. (accessed January 9, 2012).
  5. AMA (American Medical Association). 2012. C-CAT patient centered communication. (accessed January 9, 2012).
  6. America’s Health Insurance Plans. 2010. Health literacy: A toolkit for communicators. (accessed January 9, 2012).
  7. CDC (Centers for Disease Control and Prevention). 2011. CDC health literacy for health professionals training. (accessed January 9, 2012).
  8. CMS (Centers for Medicare & Medicaid Services). 2010. The toolkit for making written material clear and effective. (accessed January 9, 2012).
  9. Hablamos Juntos. 2006. Universal symbols in health care workbook. http://www. (accessed January 9, 2012).
  10. Hablamos Juntos. 2009. More than words toolkit: Improving the quality of health care translations. (accessed January 9, 2012).
  11. HHS (U.S. Department of Health and Human Services). 2010. Health literacy online: A guide to writing and designing easy-to-use health web sites. Washington, DC: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.
  12. HHS. 2007. National standards on culturally and linguistically appropriate services (CLAS). (accessed January 9, 2012).
  13. HRSA (Health Resources and Services Administration). 2012. Unified health communication (UHC): Addressing health literacy, cultural competency, and limited English proficiency. (accessed January 9, 2012).
  14. The Joint Commission. 2010. Advancing effective communication, cultural competence, and patient and family-centered care: A roadmap for hospitals. http://www.jointcommission. org/assets/1/6/ARoadmapforHospitalsfinalversion727.pdf (accessed January 9, 2012).
  15. Weiss, B. 2007. Health literacy and patient safety: Help patients understand. (accessed January 9, 2012).



Suggested Citation

Brach, C., B. Dreyer, P. Schyve, L. M. Hernandez, C. Baur, A. J. Lemerise, and R. Parker. 2012. Attributes of a Health Literate Organization. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC.


The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.

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