The most extensive Canadian research study exploring the connection between literacy and health was carried out as part of a project cosponsored by the Ontario Public Health Association and Frontier College (the “OPHA research study”).(5) This report contains numerous citations to the research literature and other sources, and also presents the findings of original research. It forms the basis for much of this present paper. As well, the more recent information reviewed and used for the completion of this paper is consistent with the picture presented in the 1989 OPHA research study.

The major finding of the OPHA research study was that low literacy levels have a major negative impact on health. In fact, literacy is one of the major influences of health status. However health is defined or measured, people with limited literacy skills are worse off than others with higher literacy skills. Literacy is a major factor underlying most other determinants of health.

Evidence for these conclusions comes from many different types and sources of information. There is extensive Canadian data, confirmed by reported findings from other jurisdictions.(6) Canada is fortunate to have carried out a number of extensive surveys examining the health of its population. For example, the National Population Health Survey was carried out by Statistics Canada in 1994-95 (findings presented in the Report on the Health of Canadians, 1996, and its companion Technical Appendix(7)). This survey — and its findings about the influence of literacy or education on health — is similar to earlier Health Promotion Surveys in 1985 and 1990.

There are also a number of other national and provincial databases. Data also comes from a variety of other sources reported in the literature. A very consistent pattern arises from all sources of information. These “hard” sources of data are confirmed by “soft” evidence, such as reports of health and literacy workers.

5 Burt Perrin. Research Report: Literacy and Health Project Phase One. Toronto: Ontario Public Health Association (OPHA). 1990. Report available from the OPHA for $10.00 (468 Queen St. East, Suite 202, Toronto, Ontario M5A 1T7; (416) 367-3313; opha@web.net). A summary of the above report can be found in: Burt Perrin. Literacy and Health: Making the Connection.” Health Promotion. Vol. 28, No. 1. Summer, 1989.

6 Canada has been recognized internationally for its extensive research and other activities in the health and literacy area. The Appendix to this report provides examples of some of the activities which have been undertaken in Canada.

7 Report on the Health of Canadians and Report of the Health of Canadians - Technical Appendix, prepared by the Federal, Provincial and Territorial Advisory Committee on Population Health for the Meeting of the Ministers of Health, September 1996. Health Canada 1996.