The causal pathways linking health literacy to health outcomes

Michael K. Paasche-Orlow*, Michael S. Wolf

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

815 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)s19-s26
JournalAmerican Journal of Health Behavior
Issue numberSUPPL. 1
StatePublished - 2007


  • Causal pathways
  • Conceptual model
  • Health literacy
  • Literacy

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health


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