Mr. Garcia is a 65-year-old pre-diabetic patient. He’s just retired and moved to a new area. At his first visit with his new PCP, a nurse asks Mr. Garcia if he can usually understand a doctor’s instructions. “Absolutely,” he says. “I understand perfectly.”

But does he really?

Situations like this highlight the importance of distinguishing between two kinds of health literacy: subjective and objective. If doctors measure just one kind of health literacy, they may miss something.

Better understanding might allow Mr. Garcia to act sooner. He might get treatment or make healthier choices — and avoid diabetes. Smart changes now could mean avoiding the pain and expense of a chronic health problem later.

That’s why, when possible, it’s best to measure both subjective and objective health literacy.

Subjective Health Literacy: What You Think You Know

Subjective health literacy measures how health literate someone thinks they are. You can gauge subjective health literacy with questions like:

“How confident are you filling out medical forms by yourself?”

The nurse in the story above was measuring subjective health literacy, albeit informally. The questions don’t have objectively correct answers, which may be less threatening. It doesn’t feel like a test you’d take in school.

But there are disadvantages too. Patients often overestimate their own ability. And they may tell you what they think you want to hear—they may report strong health literacy even if they rarely understand or act on what a doctor tells them.

Objective Health Literacy: Measuring What You Know

A patient has to actually demonstrate knowledge to measure objective health literacy. One popular tool (The Newest Vital Sign) shows the patient a nutrition label, and asks how many calories they’d get by eating multiple servings, as well as other basic questions.

With objective health literacy, you know patients aren’t overestimating their own ability, or telling you what they think you want to hear. But because there are right and wrong answers, some patients feel like they’re back in school, and the memories aren’t always pleasant.

EdLogics’ Approach to Measuring Health Literacy

EdLogics measures — and strives to cultivate — both kinds of health literacy. We use only validated surveys. When we measure objective health literacy, we present questions a little differently, making them fun, adding graphics, and incorporating great design. It’s all gamified. You can win cash drawings — the more you play, the more likely you are to win.

Users do not feel like they’re back in school.

By measuring both types of health literacy, we put ourselves in the best position to understand how health literacy changes over time. This can help us further refine our suite of health literacy education games, and be even more effective in our mission to improve health literacy.