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The relationship between poor literacy skills and health status is now well recognized andbetter understood. Interest in this relationship has led to the emergence of the concept ofhealth literacy. The concept has emerged from two different roots – in clinical care and inpublic health. This paper describes the two distinctive concepts that reflect health literacy,respectively, as a clinical ‘‘risk’’, or a personal ‘‘asset’’. In the former case a strong science isdeveloping to support screening for poor literacy skills in clinical care and this is leading toa range of changes to clinical practice and organization. The conceptualization of healthliteracy as an asset has its roots in educational research into literacy, concepts of adultlearning, and health promotion. The science to support this conceptualization is less welldeveloped and is focused on the development of skills and capacities intended to enablepeople to exert greater control over their health and the factors that shape health.The paper concludes that both conceptualizations are important and are helping tostimulate a more sophisticated understanding of the process of health communication inboth clinical and community settings, as well as highlighting factors impacting on itseffectiveness. These include more personal forms of communication and community basededucational outreach. It recommends improved interaction between researchers workingwithin the two health literacy perspectives, and further research on the measurement ofhealth literacy. The paper also emphasizes the importance of more general strategies topromote literacy, numeracy and language skills in populations
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