A silent killer maneuvers just below the surface of almost all the health issues that will lead to death and disease in the 21st century. The . population faces well-recognized health risks, including chronic diseases, environmental degradation, and natural and manmade disasters, but the silent killer is less diagnosed and remains essentially untreated. The silent killer is low health literacy: the reality that almost half of adults in the United States, over 90 million people, struggle to find, understand, and correctly use health information