Background:

Health literacy is increasingly recognised as a determinant of health and an important influence on the safety and quality of health care. However, there is considerable variation in the ways in which the term ‘health literacy’ is conceptualised and applied. Cultural and linguistic diversity introduces further complexity which must be considered in a context such as the Northern Territory.

Methods:

A comprehensive literature review and consultations with organisational stakeholders were conducted to explore issues related to the conceptualisation and measurement of health literacy with particularly relevance to the Northern Territory. Implications for organisational policy and practice and potential strategies for transfer of findings were also identified.

Results/Discussions:

There has been a shift in emphasis from a focus on consumer health literacy to the health literacy of providers (organisations, systems and staff) and other features of the ‘health literacy environment’. In an environment of high diversity such as the NT, consideration of health literacy in the context of language and culture is clearly crucial. The level of provider cultural and communication competence and health literacy will collectively determine the extent to which health care is responsive to the diverse cultural and communication needs of consumers. There is increasing recognition that health literacy, cultural and communication competence are interrelated but there have been few attempts at integration, for example, in staff training or in the development of organizational policies, standards or performance measures.

Conclusions/implications:

The evidence presented in this paper supports a coordinated approach, integrating health literacy, cultural and communication competence at organisational, system, service and individual levels. Such an approach promotes improvement across all domains to achieve culturally responsive, equitable and high quality services for all Territorians, ensuring effective communication and enhancing health literacy, to optimize health outcomes.