Health literacy is an area of practice and study that is expanding so quickly in the United States and Canada that it is difficult to keep up with the literature--not to mention the steady stream of conference notices. While this is an exciting new development for both adult education and the health professions, the history of adult literacy is crisscrossed with the tracks of "bandwagons" (Quigley, 1997). It seems that few in the current health literacy race are pausing to ask what adults with low literacy skills have actually experienced, or need, or will accept. Literature on adult learning states that adults need to be part of the learning process--that knowledge is not enough. Adult educators should be asking: "How can we approach adult learning in health settings and, in turn, enhance health learning in literacy practice to achieve a lasting impact with individuals and with the systems that are intended to serve them?" This question is discussed in this article by first looking back at the rich history of adult literacy, then presenting the lessons learned through a health literacy study in Nova Scotia as a possible way to address health literacy issues.