WHAT IS HEALTH LITERACY
Not a new concept
- To be literate1
- Increased attention: 20th century
• UNESCO: ability to identify, understand, interpret, create, communicate, compute and use
printed and written materials associated with varying contexts => !!!function in modern world
• Expanded: 21st century: includes a range of competences (reading, writing, calculating, using
money, using smartphones, driving)
- Application to the health sector since the 1970s
• Evolution: capability to understand what doctors say => expanded (take care of your own health/
take your own responsibility)
o Expanding scope and meaning (rijkwijdte & betekenis)
o Expanding body of scientific research
o Expanding political interest
Expanding scope and meaning of health literacy
- Medical public
• Medical HL: individual skills in healthcare settings
• Public HL: broader skills for disease prevention & health promotion
- Functional interactive & critical
• Functional: reading, writing, calculating in medical context
• Interactive & critical: information seeking, decision making and problem solving, critical thinking,
communication & social skills, personal and cognitive skills that are necessary to function in the
health system
Expanding research on Health Literacy (scientific research)
- First articles: 1970s now: 20.000 publications (70% in the last 5y, >1.000/year)
Political recognition of the importance of Health literacy
- UN: Views Health Literacy (HL) as essential for achieving Sustainable Development Goals (SDGs).
- WHO:
• HL improvement = key priority in Health 2020 (European Region strategy)
• HL = 1 of 3 priorities at 9th Global Conference on Health Promotion (Shanghai, 2016)
- EU: HL included in Health for Growth Programme (2014–2020).
- National level: WHO report reviews policy effectiveness at national, regional, and organizational
levels in Europe
THE EVOLVING CONCEPT OF HEALTH LITERACY
Linked to informed decision making in health:
INFORMED DECISION MAKING2
- ≠ just signing consent;
- Requires ongoing dialogue with healthcare providers
Cf. being involved in decisions, with enough information ( doctor decides, minister decides about
compulsory vaccination, …); your body, your (informed) decision
Applicable to
- Medical treatment
- Prevention & health promotion (e.g., screening, vaccination, breastfeeding)
1
To be literate= being ‘knowledgeable or educated in a particular field(s).
2
Informed decision making= make decisions based on sufficient knowledge of potential benefits and risks, and
consistent with personal values and preferences.
, Requires: Clear understanding of facts, implications, and consequences.
Find information find out about information
- Not: finding information about health
- More: judgement & finding out
• Where to look for information;
• How to interpret information;
• If the information sources that are consulted provide adequate and useful information on health
issues
• If the information sources that are consulted are reliable
A multidimensional concept: A person’s knowledge, motivation and competences to access, understand,
appraise, and apply health information in order to make judgments and take decisions in everyday life
concerning healthcare, disease prevention and health promotion to maintain or improve quality of life during
the life course.
A CONCEPTUAL MODEL OF HEALTH LITERACY
Center:
**Knowledge, competence, motivation
**Lead to skills: access, understand, appraise, apply health
information
Application areas (yellow circles):
**Health care – disease prevention – health promotion
Determinants (left side):
**Personal, situational, and societal/ environmental factors
**Influence health literacy throughout the life course
Impact (right side): individual & population level
**Health service use, health behavior
**Participation, equity, empowerment
**Outcomes: health costs, health outcomes, sustainability
HEALTH COMPETENCES
Domain Type of information Examples of skills and competencies
Disease care and Information about medical subjects Medical Recognize symptoms, follow medical instructions,
management history forms, information brochures, calculate dosage of prescribed medicine
medication leaflets
Functioning in the Information about the health care system Choice of a doctor or specialist, make an
health care system Medical insurance forms, information about appointment, ask questions to health care
rights and responsabilities professionals, take out medical insurance,
complete medical insurance claims
Prevention and Information about health risks Health items in Estimate one’s own health risks, decide on
health protection the media (TV, radio, newspapers, …), participation in screening or vaccination programs,
information about screening, health check understand health warnings on dangerous products
results, health warnings.
Health promotion Information about health determinants Buying and preparing healthy food, engage in
Articles in newspapers and magazines, healthy physical activity, quit smoking, develop and
internet sites, brochures, books maintain social contact, engage in community life
WHAT IS THE LEVEL OF HEALTH LITERACY IN THE POPULATION
Use of information sources on health (BE)
- When you have health questions, what sources of information do you consult first? For the 18-34 age group, more
people would ask for information about their health on the internet than from a specialist doctor. For all other
age groups, asking a doctor is the most common. The older one gets, the less one uses the internet as a
resource.
- When you have health related questions, what sources do you consult first? The higher the degree obtained
(University), the more people will also consult the internet for health questions. People without or only with a
secondary degree go to the health specialist noticeably more often than people with a higher degree.