Health Literacy and Numeracy

Individuals with limited health literacy have worse health outcomes (Brega et al., 2015). When developing social media messages, consider health literacy and numeracy, assess the complexity of your messages and ensure they are culturally appropriate to your intended audiences: 

  • Craft messages with simple and clear language. More than a quarter of U.S. adult residents have trouble understanding and using health information (Nielsen-Bohlman et al., 2004).
  • Help people make sense of health information and how to use it (National Cancer Institute, 2011). Functional health literacy involves understanding personal health issues and instructions (Health Literacy Centre Europe, 2015).
  • Break complex information into smaller chunks (U.S. Department of Health and Human Services, n.d.).
  • Organize information so the most important points are first (U.S. Department of Health and Human Services, n.d.).
  • Use integers instead of decimals if presenting data. They are more convincing and easier to remember (Witteman et al., 2011). Visual representations of data, such as icon arrays, are most effective.
  • Point consumers to reliable sources of information to reinforce your message, such as trusted websites or physicians.
  • Provide strategies to facilitate patient-provider communication to help patients make informed decisions (Brown et al., 2016; National Cancer Institute, n.d.).
  • Emphasize the importance of cross-cultural communication skills for providers as they play an important role in developing trust with patients and their families throughout the cancer care continuum (Kagawa-Singer et al., 2010).
  • Provide health information in languages appropriate for the target audience (McInnes & Haglund, 2011).
  • Modify messages to make them accessible to people with disabilities whenever possible to reduce disparities in health care access (CDC, 2011).
  • Use narrative stories. Exposure to fictional narratives may influence perceptions of social reality, behaviors or knowledge about health (Viswanath & Emmons, 2006).
  • Create narratives with audio and video as they are more effective than text narratives alone (Shen, Sheer & Li, 2015).
  • Use culturally resonant health promotion messages when using narratives as they may be more effective at eliciting behavior change (Larkey & Hecht, 2010).  


Brega, A.G., Barnad, J., Mabachi, N.M., Weiss, B.D., DeWalt, D.A., Brach, C., Cifuentes, M., Albright, K., West, D.R. (2015). AHRQ Health Literacy Universal Precautions Toolkit, (Second Edition). Agency for Healthcare Research and Quality

Brown, O., Ham-Baloyi, W., Rooyen, D., Aldous, C., & Marais, L. (2016). Culturally competent patient-provider communication in the management of cancer: An integrative literature review. Global Health Action, 9(1), 33208–33213.

Centers for Disease Control and Prevention. (2011). NCBDD Annual Report 2011. Retrieved from

Health Literacy Centre Europe. (2015, November 4). Understanding health literacy.

Kagawa-Singer, M., Valdez Dadia, A., Yu, M. C., & Surbone, A. (2010). Cancer, culture and health disparities: Time to chart a new course? CA: A Cancer Journal for Clinicians, 60(1), 12-39.

Larkey, L. K. & Hecht, M. (2010). A model of effects of narrative as culture-centric health promotion. Journal of Health Communication, 15(2), 114-135.

McInnes, M., Haglund, B. J. A. (2011). Readability of online health information: Implications for health literacy. Inform Health Soc Care, 36(4), 173-189.

National Cancer Institute (n.d.). Cancer types-Patient version.

National Cancer Institute. (2011). Making data talk: A workbook. 

Nielsen-Bohlman, L., Kindig, D., Panzer, A., Medicine, I., Health, B., & Literacy, C. (2004). Health Literacy: A Prescription to End Confusion. National Academies Press.

Shen, F., Sheer, V.C., Li, R. (2015). Impact of narratives on persuasion in health communication: A meta-analysis. Journal of Advertising 44(2), 105-113.

U.S. Department of Health and Human Services. (n.d.). Quick guide to health literacy.

Viswanath, K. & Emmons, K. M. (2006). Message effects and social determinants of health: Its application to cancer disparities. Journal of Communication, 56, S238-S264.

Witteman, H. O., Zikmund-Fisher, B. J., Waters, E. A., Gavaruzzi, T., Fagerlin, A. (2011). Risk estimates from an online risk calculator are more believable and recalled better when expressed as integers. Journal of Medical Internet Research 13(3), e54.