The Many Health Literacies: Advancing Research or Fragmentation?

Abstract

Health literacy is the degree to which individuals can obtain, process, understand, and communicate about health-related information needed to make informed health decisions and is an important factor in patient health outcomes and resulting health care costs. Because of its importance across many areas of health, specific attention has been given to studying and measuring health literacy in recent years; however, the field lacks consensus on how health literacy should be defined and measured. As a result, numerous definitions and measures of health literacy exist. This fragmentation and inconsistency creates a barrier to conceptualizing, measuring, and understanding health literacy across health domains and fields. A directed literature search reveals a substantial body of work on health literacy; however, findings from studies often emphasize health literacy within specific health domains, populations, contexts, and languages, which makes the comparison of findings across studies difficult. While there is recognition that the measurement of health literacy should be improved, it is important to take into consideration what can be gained from a general health literacy focus and how this could be applied across domains.

Health literacy in childhood and youth: a systematic review of definitions and models

“…mental or diabetes health literacy). However, concentrating on generic health literacy enables a broader recognition of the overall field of health literacy, hopefully preventing us from ‘not seeing the wood for the trees’ due to specific interest areas [16]. Macket et al [16] point out that a model valid for one context is less helpful for enabling knowledge construction and learning in other contexts through cross-contextual comparison and transfer.…”

“…However, concentrating on generic health literacy enables a broader recognition of the overall field of health literacy, hopefully preventing us from ‘not seeing the wood for the trees’ due to specific interest areas [16]. Macket et al [16] point out that a model valid for one context is less helpful for enabling knowledge construction and learning in other contexts through cross-contextual comparison and transfer. While this is an acknowledged problematic, we strongly stress the need to view health literacy as being socially constructed, varying according to the context one is in and the tasks at hand and hence recognising the unique characteristics of the target group.…”

“…Articles were eligible if they: a) were fully available in English or German; b) focused on generic health literacy – while excluding any domain or topic-specific health literacy models, to ensure a focus on the core dimensions of health literacy [16]; c) offered relevant content for defining and conceptualizing health literacy in children and young people and d) addressed a target population that were 18 years or younger. Articles incorporating a life course perspective on health literacy were included as well.…”

Health literacy in people with intellectual disabilities: A mixed-method literature review

“…The variety of articles may also be due to the fact that health literacy is defined for different health-related areas, populations and contexts [28]. It must be remembered that the concept is still not based on a common definition and that no standardized measurement tools have been developed.…”

“…This means that health literacy is not a fixed term and has a dynamic development. On the one hand, the concept of health literacy should not be fragmented and represented by scientific research that can be translated into many contexts to make it generalizable [28]. On the other hand, specific health literacy concepts offer great advantages [29], which also apply to research in the field of ID.…”