Barriers to Addressing Health Literacy in Rural Communities
When individuals have adequate levels of health literacy, it increases their ability to understand and use
relevant health information to make informed decisions related to health and well-being. A more complex
healthcare system demands higher levels of health literacy from people and organizations. Rural communities may
have lower health literacy rates and experience limited resources. These factors can create inequities in health
outcomes and can influence how community members interact with the healthcare system.
Many rural residents experience frequent challenges to accessing and navigating the healthcare system and, in
some cases, obtaining health information. Rural communities often experience unique needs based on their
geographic location and remoteness. Additional needs may include a lack of healthcare providers within certain
regions or limited access to culturally and linguistically adapted materials that meet the needs of
Improving health literacy can be challenging for reasons related to rural healthcare systems, community factors,
and other non-healthcare-related reasons. The Patient Safety Network (PSN) identified important factors and considerations related to health
literacy in healthcare settings that also pertain to rural patients, including:
- Most written health information materials use language that exceeds the reading level of the
- The receipt of the materials alone is not enough. Comprehension and understanding of health
information is key to improving health outcomes.
- Some patients may have disparities between written and verbal fluency, and stigma around low
literacy levels may lead to exaggeration of reading ability.
- Communication barriers impact verbal interactions between patients and providers.
- Conversations are often brief, involving complex medical jargon, and from a patient perspective can
feel largely one-sided. Patients should be engaged in a way that makes them feel comfortable and
able to listen and ask questions.
- In rural areas with fewer healthcare providers overall, a lack of culturally and ethnically diverse
healthcare providers that reflect the population can lead to distrust and ineffective communication.
- Clear and open communication between patients and providers plays a major role in treatment
adherence to help prevent serious health complications and hospitalizations.
People initiative highlights other non-healthcare challenges and social determinants of health that
impact levels of health literacy. Many rural communities continue to experience these disparities, including:
Conditions associated with living in poverty, like health insurance status (being un- or under-insured can
impact health literacy levels)
Low educational attainment, which is often associated with more limited levels of health literacy
Racial and ethnic minority groups with limited English proficiency who report having low health literacy
A lack of resources and infrastructure to address limited health literacy
For more examples of challenges and barriers to addressing health literacy
and other social determinants of health in rural areas, see the Social Determinants of Health in Rural
Resources to Learn More
Health Literacy: Hidden
Barriers and Practical Strategies
A PowerPoint presentation with speaker's notes for group dissemination or self-study that highlights the impact
of health literacy on patient outcomes and identifies evidence-based approaches for achieving higher health
Organization(s): Agency for Healthcare Research and Quality (AHRQ)
Out: Barriers to Health Equity for Rural and Underserved Communities
A report discussing the structural and root causes of inequity in health and the healthcare system. Emphasizes
the role that racism and discrimination play in care delivery and provision, especially for communities of color
and rural populations.
Organization(s): Committee on Ways and Means Majority U.S. House of Representatives