Critical health literacy: reflection and action for health

Abstract

Summary Health literacy research is growing rapidly and broadly; however, conceptual advances in critical health literacy (CHL) seem hampered by a lack of a clear definition. In this paper, we refer to key features of the concept as identified in earlier works, offer a new definition of CHL and briefly discuss its theoretical roots. Reflection and action are suggested as the two constituent components of CHL. Consequences for future research are also discussed.

Extending the sociology of candidacy: Bourdieu’s relational social class and mid‐life women’s perceptions of alcohol‐related breast cancer risk

“…Mary (aged 64, working-class) relied on 'word of mouth in my own circle of friends', and Tiffany (aged 53, working-class) described distrust in technology and instead, trust in hearing the experiences of women 'like her': 'At least you're getting facts from someone who's really had it [breast cancer] instead of just getting stuff off the internet'. These information preferences perhaps reflect skepticism about the institutions conveying health information more so than the information per se (Meyer et al, 2022) and correlates with research that suggests lower levels of cultural capital and health literacy link with reduced engagement in health promotion (Abel & Benkert, 2022). Furthermore, preferences for personal information show people can dispute the certitude of health promotion messaging when anomalies are readily identified through lay epidemiology (Davison et al, 1991).…”

A qualitative exploration of barriers to efficient and effective Structured Medication Reviews in Primary Care: Findings from the DynAIRx study

“…Areas with greater socioeconomic disadvantage often have lower health literacy, resulting from a combination of lower educational attainment, economic barriers like the need to prioritise food and heating over health seeking, and psychosocial stressors affecting decision-making relating to health. (19, 20) Health literacy applies not only to the patient but to the clinician who may also be unaware of the psychosocioeconomic situation of the patient, leading to a communication gap when discussing the risk and benefit of medicines to reach a shared-decision. Accordingly, complex conversations involving numeracy calculations of risk may take longer and require repetition, but may also be of less priority for the patient and/or carer than other more immediate life concerns.…”

Understanding Critical Health Literacy Among Adolescents: Psychometric Properties of the CHLA Questionnaire in Lower Secondary Schools in Norway

“…The social determinants of health continue to shape health behaviors and outcomes throughout the transition into adulthood 56 . Recent theoretical developments of the CHL construct support the broader scope of the CHLA‐Q measure and have emphasized the concept of reflection as the key to gaining an awareness of how social structures determine health, as well as the foundations for actions to change the realities of adolescent health in any given context 17 …”

“…The purpose of this research was to provide a valid assessment tool of CHL for researchers, teachers, and health workers involved in health education in schools. We have argued, along with others, [17][18][19]30 that most approaches to CHL in schools have focused on critical information appraisal, while the more elusive domains of understanding the social determinants of health, citizenship, and actions for health have been less explored. To amend this, the CHLA-Q was developed in the context of the Norwegian lower secondary school, and a 6-factor model of CHL was hypothesized.…”

“…15,16 The concept is not limited to individual health benefits gained from being able to critically appraise health information. Key elements of CHL also include its potential to empower people to think beyond their own perspectives, to reflect critically on how health is produced in their sociocultural contexts, 17 and to act based on these reflections. Sykes et al 18 discovered in their conceptual analysis that these more complex elements of CHL are largely not found in the present research.…”