As this paper has indicated, literacy is a major health issue. Literacy is an important factor in its own right, and closely related to practically all the major determinants of health which have been identified.

There is increasing recognition within the health sector of the importance of literacy. Over the past several years, a variety of different types of health organizations have formally recognized the connection of literacy to health, and have pointed this out to their members. The Ontario Public Health Association (OPHA), the Canadian Public Health Association (CPHA), the Centre for Literacy of Quebec and others have all undertaken activities to increase awareness and joint action. Thus some initial steps have been taken. But the links between literacy and health and the implications of this connection still are not well understood. Thus there is a need to increase awareness, across the health and social services sectors as well as among members of the general public and societal opinion leaders.

Recognition is needed at a broader societal level. But it is also important that service providers be sensitive to the importance of literacy and create a respectful environment when dealing with individuals, families, and groups. Few people will readily acknowledge that they have a problem in reading or in understanding what they are being told. To do so would require them to declare their own inadequacies or limitations.

When health practitioners are sensitive to the potential role of literacy in comprehension, they are more likely to check that what they are saying is indeed being understood and to use simpler or alternative explanations as necessary to ensure that their message actually is being received. As the OPHA research study indicates, a number of medical practitioners have indicated that they eventually came to realize that what they initially thought was lack of compliance by their patients was instead a lack of understanding.