Health Literacy: From a Property of Individuals to One of Communities

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.

Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19

“…Several articles help provide insight on these perspectives. Kendir and Breton [58] do so in "Health Literacy: From a Property of Individuals to One of Communities" as they consider this in more detail. Lorini et al [59] consider a specific topic on the influence of health literacy as a distributed resource available within an individual's social network in "Health Literacy as a Shared Capacity: Does the Health Literacy of a Country Influence the Health Disparities among Immigrants?"…”

Impact of health literacy on health practices in the working life of young Japanese nurses and care workers

“…Personal triggers, age, past history of disease, level of basically education and other socio-economic and environmental factors were reported as background factors [23][24][25][26][28][29] , but specific factors may be underlying in Japanese between health education and practices. The number of people attending lectures was low in this study.…”

“…A previous report had pointed out that there was no difference between Europeans and Japanese in knowledge and understanding for disease prevention, but a higher percentage of Japanese adults have difficulty in the assessment and use of healthcare knowledge 27 ) . Personal triggers, age, past history of disease, level of basically education and other socio-economic and environmental factors were reported as background factors 23 – 26 , 28 – 29 ) , but specific factors may be underlying in Japanese between health education and practices. The number of people attending lectures was low in this study.…”

Beyond the lessons learned from the COVID-19 pandemic: opportunities to optimize clinical trial implementation in oncology

“…In order to improve patient and relatives literacy in clinical research, dedicated sources of information should be developed. Web-based networks and compassionate communities can foster dialogue between patients and promote the exchange of information as well as literacy, participation and compliance with clinical trials ( 46 , 47 , 48 ). Finally, new opportunities to improve and simplify ICs such as applying readability methodologies ( 49 ), shortening documents and engaging patient´s advocates in IC development, will optimise patient empowerment.…”