The focus and definition of health promotion has evolved since its inception, and it continues to change in the modern age. Moving away from its more paternalistic or expert-centric origins, health promotion today is focused on enabling individuals and communities to take greater control over their own health and determinants of health (Van den Brouke, 2020). Essentially this equates to empowerment. A necessary pre-requisite to empowering people or groups to make good health choices—and something for much of mainstream society — is health literacy. Broadly, health literacy can be thought of as the acquisition and application of skills to accessing, understanding and acting on health-related information (Poueslami et al., 2017). If we really want to impact the health and well-being of individuals and communities in meaningful ways, health promotion efforts need to be more focused on health literacy.
Figure 1
Health literacy statistics
(ABC Life Literacy Canada, nd)
The impact of poor health literacy on health outcomes has perhaps never been more apparent as it has been during the COVID-19 pandemic years. Especially during the early months of the pandemic, the abundance of often conflicting and frequently changing information coming from scientific sources, traditional media, social media, and other sources created confusion and—in some cases, distrust and anger—amongst the general public (Van den Brouke, 2020). Although trustworthy sources of scientifically accurate information were and continue to be available to the public throughout the pandemic, the information needs to be understood and accepted by the public in order for it to be useful. Research has shown that at least one third of the population has trouble finding, understanding, and evaluating the basic scientific information that is required to manage their own health (Van den Brouke, 2020). The mass confusion, controversies regarding “fake news”, and public backlash against things such as mask mandates or vaccination requirements should therefor not come as a huge surprise. If the general public does not understand the information that is being presented to them from official government and public health sources, and/or are unable to evaluate and compare this information to what is being provided by other (“alternative”) sources, how can we ever expect them to make the correct or healthy choice?
It has long been established that being of lower socioeconomic status (SES) is associated with poorer health outcomes. While there are many potential reasons for this, one explanatory factor that has recently been suggested by Stormacq et al (2019) is poor health literacy. According to their review, lower educational attainment—which is associated with being of lower SES—is the most important determinant of one’s health literacy. The authors conclude that lower levels of health literacy is a mediating factor that explains the relationship between being of lower SES and having poorer health outcomes, engaging in unhealthy behaviours, and lower engagement in recommended preventative health measures (Stormacq et al., 2019).
From a health promotion perspective, a focus on health literacy needs to be approached from multiple angles. On the one hand, attention must be paid to improving health literacy of individuals and groups. This is likely a longer-term goal and might be an appropriate focus for public school curricula, for example. At the same time, a focus must be placed on the provision of appropriate, transparent, and easily comprehensible information by healthcare providers and public health officers (Poureslami et al., 2017). This means a movement away from medical and scientific jargon and a focus on making accurate and scientifically-based information more readily understood by individuals who lack a robust educational background. We need to support individuals to make healthy choices by making information readily available and easily understandable, and helping individuals and groups discern between accurate and misleading information. This is no easy task, to be sure, but the future success of health promotion efforts requires a renewed emphasis on this.
References
ABC Life Literacy Canada (nd). Health literacy statistics [infographic]. ABC Life Literacy Canada website. https://abclifeliteracy.ca/health-literacy/
Poureslami, I., Nimmon, L., Rootman, I., & Fitzgerald, M.J. (2017). Priorities for Action: Recommendations from an international roundtable on health literacy and chronic disease management. Health Promotion International, 32. 743-754. https://doi.org/10.1093/heapro/daw003
Stormacq, C., Van den Broucke, S., & Wosinski, J. (2019). Does health literacy mediate the relationship between socioeconomic status and health disparities? Integrative review. Health Promotion International, 34 (5), e1-e17. https://doi.org/10.1093/heapro/day062
Van den Broucke, S. (2020). Why health promotion matters to the COVID-19 pandemic, and vice versa. Health Promotion International, 35 (2), 181-186. https://doi.org/10.1093/heapro/daa042
Comments