The World Health Organization defines health literacy as cognitive and social skills determining individuals' motivation and ability to receive, understand, and use information in a health-promoting manner. This study discusses health literacy in the light of general upper secondary education students' test answers (N = 611) on the Finnish Matriculation Examination. The data were analyzed based on three levels of health literacy: the basic, communicative, and critical level. Analysis suggests the three existing levels do not fully describe the depth of health literacy. A fourth level was derived, called "holistic health literacy," with the following dimensions: (1) tolerance, (2) understanding culture as wide and multidimensional phenomena, (3) environmental consciousness, and (4) analysis of the state of the world from various points of view. The means of developing the subject of health education are discussed.

Youngsters’ health is widely studied from various points of view but a holistic approach to health has been minimal. The purpose of this research was to study general upper secondary education students’ health knowledge and perceptions of health by analyzing their answers concerning the subject of health education in the general studies battery of tests in the Finnish matriculation examination. The sample of the research consisted of 611 essays that were the test answers in health education in 2007. The essays covered altogether eight questions about health education. 81 candidates for the spring 2007 matriculation examination and 60 candidates for the fall 2007 matriculation examination participated in this research; altogether 141 candidates. The research approach was phenomenological-hermeneutic. The data was analyzed through qualitative content analysis. According to the results, students recognized people’s responsibility for their own health. They disapproved especially those who consciously neglect their health. According to the findings, it seemed evident that health education as a subject should be further developed so that it supports youngsters’ health appreciation and ability to make health-promoting choices in life. This decade sets special challenges to health education in schools, and therefore, it is important to listen to the youth‘s opinions and perceptions of health in order to, for example, develop curriculum planning. Key words: health, health education, matriculation examination, general upper secondary education.

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