Health literacy and knowledge of chronic disease

Julie A. Gazmararian, Mark V. Williams, Jennifer Peel, David W. Baker

Research output: Contribution to journalArticlepeer-review

673 Scopus citations


We sought to examine the relationship between health literacy and knowledge of disease among patients with a chronic disease. A total of 653 new Medicare enrollees aged 65 years or older who had at least one chronic disease (115 asthma, 266 diabetes, 166 congestive heart failure, 214 hypertension), completed both the in-person and telephone survey. Health literacy measured by the short test of functional health literacy in adults (S-TOFHLA) and demographic information were collected during the in-person survey. Knowledge of disease was assessed by questions based on key elements in educational materials during a telephone survey. Overall, 24% of patients had inadequate and 12% had marginal health literacy skills. Respondents with inadequate health literacy knew significantly less about their disease than those with adequate literacy. Multivariate analysis indicated that health literacy was independently related to disease knowledge. There are many opportunities to improve patients' knowledge of their chronic disease(s), and efforts need to consider their health literacy skills.

Original languageEnglish
Pages (from-to)267-275
Number of pages9
JournalPatient Education and Counseling
Issue number3
StatePublished - Nov 2003

Bibliographical note

Funding Information:
This work was partially supported by a grant from The Robert Wood Johnson Foundation. The study was performed and supported by the Prudential Center for Health Care Research, which became the USQA Center for Health Care Research™, now the Emory Center on Health Outcomes and Quality.


  • Asthma
  • Congestive heart failure
  • Diabetes
  • Health literacy
  • Hypertension
  • Managed care
  • Patient education

ASJC Scopus subject areas

  • General Medicine


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