Academy Comments to Updated Health Literacy Definition for Healthy People 2030

August 5, 2019

Stephanie Santana
Public Health Analyst
U.S. Department of Health and Human Services
Office of the Assistant Secretary for Health
Office of Disease Prevention and Health Promotion
1101 Wootton Parkway
Rockville, MD 20852

Re: Updated Health Literacy Definition for Healthy People 2030

The Academy of Nutrition and Dietetics appreciates the opportunity to submit comments on the Updated Health Literacy Definition for Healthy People 2030. As the largest association of nutrition and dietetics practitioners1, the Academy is committed to a world where all people thrive through the transformative power of food and nutrition.

The Academy supports the definition of health literacy for HP2030 as we agree with the shift from a sole focus on individual-level capacities to obtain, process, and understand basic health information, to a focus on accessibility of health information and services. The working definition for HP2030 is similar to the definition issued by the Agency for Healthcare Research and Quality,2 and is also consistent with the socio-ecological approach applied by Community Tool Box Services, Center for Community Health and Development at the University of Kansas.3 We agree with the conceptual shift from health literacy as an attribute of persons to one of society in which ownership and accountability for literacy's components are distributed to all.

Since access and uptake of health communications may be dependent on other criteria, the Academy is also exploring inclusion of these other factors in health literacy: culture, behaviors, attitudes, current health concerns and social determinants of health.4,5 At some point in the HP2030 process, ODPHP may want to consider exploring the impact of these additional factors in the definition of health literacy.

Sincerely,

Jeanne Blankenship, MS, RDN
Vice President
Policy Initiatives and Advocacy
Academy of Nutrition and Dietetics

Mark E. Rifkin, MS, RD, LDN
Manager
Consumer Protection and Regulation
Academy of Nutrition and Dietetics


1 1. The Academy represents over 107,000 registered dietitian nutritionists (RDNs), nutrition and dietetics practitioners, registered, and advanced-degree nutritionists. The Academy has approved the optional use of the credential "registered dietitian nutritionist (RDN)" by "registered dietitians (RDs)" to more accurately convey who they are and what they do as the nation’s food and nutrition experts. The RD and RDN credentials have identical meanings and legal trademark definitions.

2 "Health Literacy." Agency for Healthcare Research and Quality. Accessed August, 2019.

3 "Community Tool Box." Center for Community Health and Development, University of Kansas.

4 Carbone ET, Zoellner JM. Nutrition and health literacy: a systematic review to inform nutrition research and practice. J Acad Nutr Diet. 2012;112(2):254-265.

5 Thomas H, Azevedo Perry E, Slack J, et al. Complexities in Conceptualizing and Measuring Food Literacy. J Acad Nutr Diet. 2019;119(4):563-573.