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The causal pathways linking health literacy to health outcomes
Michael K Paasche-Orlow1, Michael S Wolf
1Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston University Medical Center, Boston, MA 02118, USA. mpo@bu.edu
Objective:
To provide an evidence-based review of plausible causal pathways that could best explain well-established associations between limited health literacy and health outcomes.
Methods:
Through analysis of current findings in medical and public health literature on health literacy we derived a conceptual causal model.
Results:
Health literacy should be viewed as both a patient and a system phenomenon. Three distinct points along a continuum of health care are suggested to be influenced by health literacy: (1) access and utilization of health care, (2) patient-provider relationship, and (3) self-care.
Conclusions:
The conceptual model organizes what has been learned to date and underscores promising areas of future inquiry and intervention.
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