Health Literacy: From a Property of Individuals to One of Communities
Open Access
- 1 March 2020
- journal article
- research article
- Published by MDPI AG in International Journal of Environmental Research and Public Health
- Vol. 17 (5), 1601
- https://doi.org/10.3390/ijerph17051601
Abstract
Health literacy (HL) is increasingly hailed as a strategy to improve the control individuals have over their health. A central critic of HL intervention is its overemphasis on individual level factors, something recognised in the 2008 report of the Commission of Social Determinants of Health (SDoH) that recommended expanding the scope of HL to cover the SDoH. The objective of our study was to assess the extent to which recent progress on HL captures the need for collective action on the SDoH. We conducted a scoping review on PubMed looking for review papers published between 2013–2018 in English and French. Definitions of HL were analysed against two main dimensions (i.e., locus of change of HL strategies and foreseen outcome of HL improvements). Despite a number of authors calling for more research on HL interventions at the community level and an expansion of the definition to cover the SDoH, we found that the recommendation of the Commission has yet to be implemented. Even when the definitions include the capacities of individuals on distal determinants, both the locus of change and outcomes of HL improvement do not go beyond intra individual factors (knowledge, skills, etc.). It is noteworthy that communities were either framed as a setting outside of health care services or as an aggregate of individuals. We found no instance of HL intervention regarding communities as complex systems of actors sharing a common space and dynamic. We conclude by suggesting a new definition of HL and by drawing attention to the research gap in addressing the upstream SDoH through HL actions.Keywords
This publication has 43 references indexed in Scilit:
- Health literacy and public health: A systematic review and integration of definitions and modelsBMC Public Health, 2012
- Health Literacy: What Is It?Journal of Health Communication, 2010
- Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy ImplicationsJournal of Health and Social Behavior, 2010
- Bilingual health literacy assessment using the Talking Touchscreen/la Pantalla Parlanchina: Development and pilot testingPatient Education and Counseling, 2009
- Health Literacy for Improved Health Outcomes: Effective Capital in the MarketplaceJournal of Consumer Affairs, 2009
- The evolving concept of health literacySocial Science & Medicine, 2008
- Patient health literacy and participation in the health‐care processHealth Expectations, 2008
- Understanding health literacy: an expanded modelHealth Promotion International, 2005
- Health Literacy: Report of the Council on Scientific AffairsJAMA, 1999
- Health promotion glossaryHealth Promotion International, 1986