I often
wonder if thinking people outside the healthcare and education professions
are attuned to health literacy.
And if they are, how do they see it? We asked members of linkedin, the
self-proclaimed world’s largest
professional network, “What does health literacy mean to you?” Indeed business
people, especially those on
the business side of health and healthcare, are thinking about health
literacy, and as we should expect,
from their perspectives, the meaning of health literacy is similar but
different from clinicians’ and
researchers’ views. An individual capacity Like most
clinicians and researchers, all linkedin respondents view health literacy as an
individual capacity. The difference is this: most research limits the concept
to patients in clinical settings
while business professionals see health literacy extending to work and home
to include choices and actions
related to healthy living, diet, sleep, stress, and, as Henri V writes,
“things they can do to improve/maintain
their health”. I agree with this broader view, which aligns with the health
promotion model of health
literacy and the World Health Organization’s definition.
And I have argued that communities can have high
or low health literacy, too. Role of knowledge In both clinical
and business perspectives, there is a strong emphasis on knowledge. While
clinicians focus on disease knowledge, the business professionals emphasize
personal health knowledge, what
Angela V, founder of DocRate.net calls “the know-how available for healthy
living”. Chenbagam P., adviser to
an ayurveda clinic, describes it as “the true knowledge of our body
mechanism”, in the same way a motor
mechanic understands a motor. From my health promotion/health literacy
researcher perspective, knowledge
plays a big role; and our Puritan heritage that dictates we do not talk about
bodily functions results in
large gaps in knowledge of how our bodies work. But, disease and medical
knowledge is appropriately gained
with need and experience. Why would a person learn all about pulmonary
disease unless and until they are
living with it? Interaction & Reflection:
health literacy skills More important than specific knowledge, I think, is ability to
formulate a question and interact with those who know, what Vincent V, a
wellness coach, describes as “a
responsible discussion with a medical doctor”, and may include a range of
health/medical experts. Interaction (a set of
social skills) is considered an advanced literacy and health literacy skill.
The most important health knowledge
may be how to think about and plan for health, as Bonnie Z, a corporate writer
says, “using information to make
healthy choices.” A good simple (but not easy) process for empowering
individuals as “activated patients” is Dynamic Tension. Spencer C,
a hospital director, addresses the reflective/critical aspect of health
literacy, which he describes as the
‘basic ability to evaluate all of these aspects [of lifestyle] and assess
your choices based on their impact on your
overall health.” In contrast, most clinicians and researchers focus on lack
of basic literacy skills (reading and
numeracy) and address low health literacy as a cognitive deficit in patients.
Reflection is typically described as an
advanced literacy skill and, in the health promotion model, as a health
literacy skill needed to personalize information and apply it in context for
personal benefit. I agree with literacy scholars who say reflection is so necessary
to using information rather than simply decoding the meaning, that it should
be categorized as a basic
skill – the 4 R – Reading, ‘Riting, ’Rithmatic and Reflection. From this
informal unscientific poll, it appears that linkedin members subscribe to the
broader health promotion view of
health literacy, which, simply stated is ability to use information for
health. Thanks for thoughtful commentary.
ss Reference & Further Reading Culligan,
N. (2005) Theoretical understandings of
adult literacy: A literature review. Wellington, NZ: Massey University.
Emerald,
D. (2009). The power of TED: The
Empowerment Dynamic (2 ed). Bainbridge Island, WA: Polaris Press. www.powerofted.com/ Lonsdale,
M., & McCurry, D. (2004). Literacy
in the new millennium. Adelaide, Australia: National Center for
Vocational Education Research Nutbeam,
D. (2008). The evolving concept of health literacy. Social Science & Medicine, 67, 2072-2078. Pleasant,
A., & Kuruvilla, S. (2008). A Tale of Two Literacies: Public health and
clinical approaches to health literacy. Health Promotion International, 23 (2),
152-159. |
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