In New Zealand, health literacy has been defined as 'the capacity to obtain, process and understand basic health information and services in order to make informed and appropriate health decisions' (Ministry of Health, 2010). This is one of the older definitions of health literacy and, on the face of it, has a consumer deficit focus. Reading between the lines, the roles of the health system, health care provider and health practitioners are crucial to health literacy. The health system is responsible for funding health services (and information about services). The health care provider is responsible for delivering services and communicating information. The health practitioners are responsible for making sure that appropriate information is provided to consumers in a way that makes sense to consumers. The health provider and health practitioners also need to identify and remove any barriers to a person taking action on the new health information they have obtained.

A similar concept is conveyed by the Institute of Medicine (2004) where health literacy is described as the interaction between the skills and knowledge of individuals and the demands of the health system (Institute of Medicine 2004). Because of the way health systems and services are designed and delivered, consumers face a series of demands on their health literacy. These demands impact on consumers' ability to access health information, care and services. In many health settings there is a significant mismatch between the skills and knowledge consumers need in order to meet the health literacy demands imposed by the health system, and consumers' actual health literacy skills and knowledge.