US Health Literacy Scores

This website provides an interactive, searchable, national map of health literacy estimates for 216,864 census block groups in the United States. There are usually between 600 and 3,000 people living in a census block group.

Health literacy is the ability to obtain, process, and understand information needed to make health decisions. Health literacy is not only a reflection of an individual’s skills and abilities, but also how well health systems provide information and services.

This map will help identify geographic areas that may be most affected by limited health literacy and are in the greatest need of health care services and improvements. The literacy estimates may also be used to study health literacy on a larger scale than previously possible with assessments administered in person.

These health literacy estimates were created through a predictive model that uses data from the 2010 U.S. Census and 2011 5-year American Community Surveys (ACS) summary files. This predictive model estimates the mean health literacy of individuals living in each census block group.

We included the following variables in the model:

Gender
Age
Race/ethnicity
Language spoken at home
Income
Education
Marital status
Time spent in the United States
Metropolitan statistical area

A note on limitations to this model: It’s important to realize that these are health literacy estimates based on demographic characteristics of census block groups. Therefore, the estimates may not be accurate for every person who lives in a particular census block group.

If you’re interested in additional information on the model used to create these estimates, please review this publication. You can also contact us with questions.

Please note: The map and the underlying data driving the geographic representations are publically available to inform and benefit policy and practice. Find information about how to use and cite the data.

The development and maintenance of this website was funded by National Institute on Aging (NIA) (Grant Number: 1R01AG046267-01A1; PIs: Bailey/Fang) and is a collaboration between the University of North Carolina at Chapel Hill, Boston University Medical Center, Northwestern University, RAND Corporation, and the University of Michigan.

Disclaimer: The content of this website does not necessarily represent the official views of the National Institutes of Health (NIH).

Next: Understanding the Data.

You can download health literacy estimates for every census block group in a particular state—or for the entire United States.

Download state-specific estimates.

Download national estimates.

Find information on how to categorize estimates.

Please note that health literacy estimates for individual census block groups may be unique. It’s important to know that integrating these estimates into data sets could make data identifiable.

This map and associated data are available for public use through funding by the National Institutes on Aging. We ask that you make sure to cite this website and the grant number (1R01AG046267-01A1; PIs: Bailey/Fang) in any publications or products that use this data.

Suggested citation for this website (replace June 1, 2015 with the date you accessed the site):

MLA: National Health Literacy Mapping to Inform Health Care Policy. Health Literacy Data Map. University of North Carolina at Chapel Hill, 2014. Web. 01 June 2015.
APA: National Health Literacy Mapping to Inform Health Care Policy (2014). Health Literacy Data Map. University of North Carolina at Chapel Hill. Retrieved June 1, 2015, from [website link]
Chicago: National Health Literacy Mapping to Inform Health Care Policy. “Health Literacy Data Map.” University of North Carolina at Chapel Hill. [website link] (accessed June 1, 2015).

The health literacy estimates on this site range from 177 to 280, with higher numbers indicating higher health literacy. The health literacy estimates are based on the 2003 National Assessment of Adult Literacy (NAAL). Learn more about the NAAL.

This national survey categorized literacy skills into the following 4 categories: Below Basic, Basic, Intermediate, and Proficient.

Category	Score
Below Basic	0-184
Basic	184-225
Intermediate	226-309
Proficient	310-500

Adults with Below Basic health literacy skills may be able locate information in simple text (e.g., the time of their next clinic visit from an appointment slip), but would struggle with information in more complex documents.
Adults with Basic health literacy skills are able to locate multiple pieces of information in a document, but may have difficulty interpreting or applying this information (e.g., determining whether their body mass index is in a healthy range).
Adults with Intermediate health literacy skills can often understand and apply medical information to their specific health context, but may have difficulty navigating multiple complex texts (e.g., consent forms or health insurance documents) or drawing inferences from health materials.
Adults with Proficient health literacy skills are able to use a table to calculate an employee’s share of health insurance costs.

Read more about these categories.

There are 4 different ways to interpret and use the health literacy estimates. Use the related buttons in the legend of the map to see census block groups categorized by each of these 4 criteria.

1) Percentage of People with Below Basic/Basic Health Literacy:

For each census block group, we used a predictive model to estimate the percentage of people in each census block group who are likely to have Below Basic or Basic skills according to the NAAL criteria. This percentage is shown when you click on any census block group in the map.

Find more information on generating these percentages (PDF – 4.7MB).

2) NAAL Category:

We categorized census block groups as Below Basic/Basic or Above Basic based on their health literacy estimate:

Above Basic – health literacy estimate over 225
Below Basic/Basic – health literacy estimate of 225 or lower

3) National Quartile:

We split all health literacy estimates generated by the predictive model into 4 even categories (quartiles) based on the range of scores for the entire United States. To see census block groups categorized this way, click on the National Quartile radio button in the legend.

Category	Score
Quartile 1 (lowest)	235 or lower
Quartile 2	Higher than 235 to 247
Quartile 2	Higher than 247 to 254
Quartile 4 (highest)	Higher than 254

4) State Quartile:

We split the health literacy estimates for each state evenly into 4 categories (quartiles) based on the range for scores for that state. Learn more about quartiles for each state.

Questions? Feel free to contact us.

State	Q1	Q2	Q3	Q4
AK	0-244	245-252	253-257	258-500
AL	0-231	232-242	243-250	251-500
AR	0-235	236-243	244-250	251-500
AZ	0-232	233-245	246-255	256-500
CA	0-225	226-240	241-252	253-500
CO	0-242	243-253	254-262	263-500
CT	0-240	241-251	252-258	259-500
DC	0-219	220-234	235-262	263-500
DE	0-238	239-245	246-253	254-500
FL	0-229	230-241	242-249	250-500
GA	0-229	230-241	242-251	252-500
HI	0-232	233-239	240-245	246-500
IA	0-246	247-250	251-255	256-500
ID	0-245	246-251	252-257	258-500
IL	0-235	236-248	249-255	256-500
IN	0-243	244-248	249-254	255-500
KS	0-244	245-250	251-257	258-500
KY	0-241	242-246	247-253	254-500
LA	0-226	227-240	241-249	250-500
MA	0-244	245-254	255-260	261-500
MD	0-232	233-246	247-256	257-500
ME	0-248	249-252	253-257	258-500
MI	0-241	242-249	250-255	256-500
MN	0-247	248-253	254-260	261-500
MO	0-242	243-248	249-255	256-500
MS	0-225	226-238	239-247	248-500
MT	0-247	248-251	252-257	258-500
NC	0-234	235-244	245-253	254-500
ND	0-247	248-252	253-259	260-500
NE	0-245	246-251	252-259	260-500
NH	0-250	251-255	256-260	261-500
NJ	0-232	233-247	248-256	257-500
NM	0-225	226-236	237-246	247-500
NV	0-231	232-242	243-250	251-500
NY	0-227	228-247	248-255	256-500
OH	0-242	243-248	249-254	255-500
OK	0-238	239-245	246-252	253-500
OR	0-244	245-251	252-257	258-500
PA	0-242	243-248	249-254	255-500
RI	0-241	242-251	252-258	259-500
SC	0-231	232-242	243-251	252-500
SD	0-244	245-250	251-256	257-500
TN	0-238	239-245	246-253	254-500
TX	0-223	224-239	240-251	252-500
UT	0-249	250-257	258-263	264-500
VA	0-238	239-247	248-256	257-500
VT	0-249	250-253	254-258	259-500
WA	0-246	247-252	253-258	259-500
WI	0-246	247-251	252-257	258-500
WV	0-242	243-246	247-251	252-500
WY	0-248	249-252	253-256	257-500

Please feel free to contact us with questions or comments. We look forward to hearing from you.

Gang Fang, PharmD MS PhD
Assistant Professor
Division of Pharmaceutical Outcomes and Policy
UNC Eshelman School of Pharmacy
2202 Kerr Hall
Chapel Hill, NC 27599-7573
Office Phone: 919-966-7517
Fax: 919-966-8486
Email:
Website: https://pharmacy.unc.edu/directory/gangfang/

Stacy Cooper Bailey, PhD MPH
Assistant Professor
Division of Pharmaceutical Outcomes and Policy
UNC Eshelman School of Pharmacy
2204 Kerr Hall
Chapel Hill, NC 27599-7573
Office Phone: 919-843-9834
Fax: 919-966-8486
Email:
Website: https://pharmacy.unc.edu/directory/scbailey/

The health literacy estimates on this site range from 177 to 280, with higher numbers indicating higher health literacy. Individuals living in communities with low literacy estimates may be more likely to have problems reading and understanding basic health information, like a pamphlet about a medical condition. Those living in neighborhoods with higher literacy scores may be able to understand basic health information, but could have difficulty with more complex text, such as documents describing medication side effects or insurance coverage.

More information can be found in Understanding the Data.

The health literacy estimates shown on this site can be categorized in many ways.

Select NAAL categories to see the neighborhoods shown as basic/below basic vs. above basic literacy (Learn more about the NAAL.).
Select State Quartiles to see the estimates divided into 4 categories based on the range of scores for the state.
Select National Quartiles to see 4 categories based on the range of scores for the entire US.
Select Base Map to see landmarks and roads for the area

More information can be found in Understanding the Data.