Health literacy and patient empowerment in health communication: the importance of separating conjoined twins.

OBJECTIVE: Patient empowerment and health literacy have both been studied empirically, but they have hardly ever been explicitly linked.
METHODS: Pertinent literature from the development of both concepts was studied, drawing not only on health care literature, but also on management research.
RESULTS: This article argues that it is important to recognize that the concepts are distinct, both conceptually and empirically. At the same time, the impacts of health literacy and patient empowerment are deeply intertwined. High literacy does not necessarily entail empowerment and vice versa, and mismatches of the two can have deleterious consequences. High levels of health literacy without a corresponding high degree of patient empowerment creates an unnecessary dependence of patients on health professionals, while a high degree of empowerment without a corresponding degree of health literacy poses the risk of dangerous health choices.
CONCLUSION: We discuss the importance of carefully conceptualizing both approaches, the implications for their measurement and the design of health interventions. PRACTICE IMPLICATIONS: Communication programs must include the empowerment that motivates consumers to engage and the literacy that enables them to make informed and reasoned choices.