The increasing emphasis on managed health care, which requires health consumers to make complex decisions, is reinforcing the importance of literacy skills. "Health literacy," which refers to the ability to engage in such activities as health-related critical thinking, problem solving, self-directed learning, and self-advocacy, is emerging as a distinct concept. Numerous studies have confirmed the connection between poor health status, poverty, and low educational attainment. Consequently, closing the health-literacy gap is a fairness and equity issue. Adult literacy educators can help close the health-literacy gap on two fronts: (1) they can collaborate with health professionals by providing training in appropriate and culturally sensitive ways to work with low-literate adult clients; and (2) they can help adult learners develop the skills to communicate assertively and confidently with their health care providers. The participatory approach to adult literacy education is particularly well suited to integrating literacy education and health promotion. An important component of participatory literacy is critical literacy. Adult educators, health educators, health care providers, and literacy learners must collaborate to increase awareness of health and literacy issues and develop appropriate materials and programs to close the health-literacy gap. (Contains 14 references.) (MN)