Socioecological approaches to communication consider people's language behaviors as nested within multilevel sociocultural systems. In contrast, psycholinguistic approaches consider people's language behaviors as a collection of person-specific experiences and capacities (Itzhak et al., 2017). Both approaches are relevant to understanding real-world communicative needs, such as health literacy in multilingual settings. While health literacy in a first (L1) or second language (L2) is crucial for comprehending health information, the precise determinants that influence health literacy (e.g., text characteristics, reader characteristics, and multilayered socioecological context) remain unclear, particularly for people living within language-discordant contexts (i.e., where the language of the environment differs from one's L1). To address these issues, we review health literacy as it pertains to multilingualism and emphasize the relevance of psycholinguistic studies of written language processing, individual differences in L1 and L2 reading skills, and language experience. Our goal is to synthesize information that could be useful for maximizing health literacy and reducing linguistic barriers, by expanding upon existing health literacy frameworks to the domain of multilingualism.What is the significance of this article for the general public?We review how the socioecological context of multilingualism, and the psycholinguistic behaviors of multilingual people jointly impact health literacy. We address health literacy challenges in multilingual adults, and how psycholinguistic phenomena reported for multilingual adults might address these challenges. We hope this review advances interdisciplinary efforts to characterize and overcome language barriers in health care access.