Mind the Gap: why poor literacy is a public health issue – and what we can do about it

We’ve reached the final stop on our Mind the Gap journey. Throughout this campaign, we’ve explored how literacy shapes life chances – but its impact doesn’t stop at school or work. In this final stage, we’re focusing on a serious and often overlooked consequence of poor literacy: its role as a public health issue, and how this ultimately affects life expectancy.

Poor literacy doesn’t just make everyday tasks harder. It makes it harder for people to understand, navigate and take control of their own health. When someone struggles with reading or comprehension, essential tasks become barriers – from interpreting instructions from a doctor, to understanding medicines, to making sense of appointment letters or test results.

The effects echo across a lifetime. In England, life expectancy can differ by as much as 26 years between communities with the highest literacy levels and those with the lowest. And because children of adults with low literacy skills are far more likely to face literacy challenges themselves, these health inequalities don’t just affect individuals ‑they continue from one generation to the next.

Below, we break down five key facts about how the literacy gap fuels health inequalities, and what we can do to break the cycle.

Five key facts about the impact of poor literacy on health

1. Low literacy directly harms health outcomes

“43% of working-age adults in England struggle to understand text-based health information well enough to make health decisions” (Public Health England)

Without clear understanding, people can misinterpret prescriptions, misunderstand treatment options, or miss crucial self-care steps. This increases the likelihood of preventable complications, poorer recovery, and delayed care. Low literacy also makes navigating healthcare systems – from booking appointments to accessing services – significantly harder.

2. Poor literacy drives preventable illness, hospitalisations and early mortality

“Low health literacy has been linked to poor general health, increased hospital admissions, low use of preventative services and reduced life expectancy.” (NIHR Evidence)

When people can’t understand or act on health information, they are less likely to recognise early symptoms, less able to follow treatment plans, and less likely to access preventative services like screening or vaccination. This leads to more serious illness later on, avoidable emergency care, and shorter healthy life expectancy.

3. Literacy is central to addressing health inequalities across the UK

“[Poor literacy] limits opportunities… to be actively involved in decisions about their health… and the most disadvantaged groups in society… are known to have the poorest health outcomes.” (Public Health England)

Literacy underpins equitable access to healthcare. It affects people at every age – from childhood development and long‑term conditions in adulthood to the ability to manage complex medication or care plans in older age. When literacy levels are low, health inequalities widen, especially in already disadvantaged communities.

4. Low literacy increases vulnerability to misinformation and poor decision-making

“10 million UK adults lack health literacy, creating a ​“fertile environment for misinformation.” (NHS Knowledge & Library Services)

Low literacy reduces someone’s ability to evaluate whether information is trustworthy. This makes harmful myths and false health claims more likely to spread – especially online. In turn, misinformation can prevent people from seeking care, lead to unsafe self-treatment, or discourage uptake of effective medical interventions.

5. Low literacy increases NHS costs and service pressures

“The economic cost to the NHS of poor health literacy was estimated at £2.95 – £4.92 billion per year.” (NHS Knowledge & Library Services)

People with low literacy are more likely to rely on emergency care and less likely to access preventative services. This places additional pressure on GPs, A&E departments and urgent care. Improving literacy not only supports better health – it reduces avoidable strain on the NHS and helps create a more sustainable health system for everyone.

Breaking the cycle: how to close the literacy gap

Parents with low literacy levels are significantly more likely to have children who struggle with literacy too. Without support, this cycle continues – and so do the health inequalities tied to it. Tackling this early is essential.

By volunteering just twice a week for 30-minutes you can give a child the one-to-one reading support they need to build they skills and confidence. Beyond opening doors to learning, careers and life opportunities, becoming a confident reader gives a child something even more fundamental: the ability to understand and make decisions about their own health and wellbeing as they grow.

When we close the literacy gap, we close the health gap too.