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
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.