Strong health literacy skills empower people to make informed health decisions, especially those with chronic health conditions striving for positive health outcomes. Half of all people living in Maryland report having at least one chronic disease. Research examining the health literacy of Marylanders is limited. This paper reports how establishing a baseline for health literacy levels of Marylanders can identify major factors affecting the health literacy skills of Extension audiences and lays the important groundwork to develop Extension programs and explore the best delivery methods tailored to the needs of subpopulations. Using the Newest Vital Sign, a validated tool that uses the Nutrition Facts label for measuring health literacy, a cross-sectional study surveyed 636 people living in 23 counties and Baltimore City. The tool was adapted to include the new Nutrition Facts label (effective 2020). Results indicated education (p < .001), race (p < .001), and gender (p = .02) were strongly associated with an individual’s health literacy. Extension educators should not make assumptions that the health information they provide is easily understood. Further, they should explore the best approaches to assess the health literacy skills of their target audiences to ensure that information is clearly communicated and can be used to make informed health decisions.



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