IALS has also identified a number of subgroup differences. In particular, it indicates that the literacy levels of older adults are dramatically lower than for others. For prose literacy among adults over age 65, 53 percent are at Level 1, with an additional 27 percent at Level 2. Just 19 percent have the minimum skills considered necessary to fully function.

As the IALS Canadian report indicates: “The consequences of low literacy for Canadian seniors have been explored in a variety of studies. Seniors with low literacy skills are restricted in their activities and often depend on others to cope with the literacy activities of daily living.” This means that many older adults are limited in their ability to understand information about health and to use health care services.(4)

Following are some major implications of the International Adult Literacy Survey (IALS) findings about literacy levels among Canadians:

• Literacy is not either-or, but represents a continuum of different skill levels. Very few people are completely unable to read or write anything. But a very high proportion — nearly half of adult Canadians — have literacy skills which are sufficiently limited to affect their ability to function in society. These people are especially vulnerable to changes in circumstances or contexts, such as changes in their job requirements or employment situation.

• Prior knowledge and the familiarity of the context has an important impact on the ability of people to understand written and oral information. This means, for example, that the ability to understand health communications can depend in part on one’s previous acquaintance with the topic and the extent to which the information is related to what one already knows.

• The above findings are not well recognized or accepted by the public at large, by health professionals — and by individuals about their own literacy skills. Among Canadians with low literacy skills, only a small proportion acknowledge this limitation or go on to participate in literacy or adult upgrading courses.

4 NLS recently has commissioned a monograph from the University of Regina, which will use the IALS database for a more in-depth look at the impact of literacy levels on the socio-economic status and health of older adults.