Making a Case for “Education for Health Literacy”: An International Perspective

Abstract

In many countries, health literacy research, practice, and policy have been moving away from a focus only on medical care and health-care settings to a much broader conceptualization. In this broader perspective, health literacy can be obtained and used across many other settings (e.g., school, home, workplaces, government) towards achieving health and wellness goals across the life-course for individuals, families, and communities. The education sector is a critical domain towards these achievements and education for health literacy is a fundamental process and outcome. This can help towards important public health goals, including critical health literacy, as oriented not only towards individual actions, but also towards supporting effective social and political action. This Perspective Article describes the importance and utility of the education for health literacy perspective, which, follows a view that health literacy is a key outcome of health education from which improved population health, health promotion and disease prevention could be achieved across diverse contexts. We first describe different educational paradigms to address health literacy and clarify the education for health literacy perspective as a supportive, instructional and capacity-building global resource across the life-course. Then, using specific examples from Canada, America, and Germany, we provide a snapshot of the diverse ways in which the education for health literacy perspective can be found in national policies. These include broad national goals and standards (Germany and Canada) and major health care reform (America). We next consider the tensions and gaps that can arise in the translation and implementation of these policies relative to the ideal education for health literacy perspective, especially related to equity. These include the need for funding, goals of the educational system, and limited evaluation of policy in practice. Finally, we highlight strategic opportunities to achieve education for health literacy and equity especially offering examples from innovative practice in Canada across the lifespan.

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

“…Hofer-Fischanger et al [91] give us new insights into active living and health literacy in "Health Literacy and Active Transport in Austria: Results from a Rural Setting", providing useful guidance. In "Making a Case for 'Education for Health Literacy': An International Perspective", Vamos et al [92] describe critical perspectives on merging health literacy in the educational sector across contexts and how to bring policy into practice. Mansfield et al [93] should provide valuable policy-level perspectives in "Integrating a Health Literacy Lens into Nutrition Policy in Canada".…”

Trends in coverage of hygiene and disease prevention topics across national curriculum frameworks for primary science, physical education, and health

“…In contrast to science education, in health literacy there is a recognized need for adaptation to local contexts (e.g., Rimal and Lapinski 2009 ; Zanchetta et al 2012 ; Escoffery et al 2018 ) and international consensus in the definition of health literacy is still developing (Lynch and Soukup 2016 ; Vamos et al 2020 ). This emphasises the specific risk of “policy borrowing” in the context of health education.…”

Moving Health Literacy Research and Practice towards a Vision of Equity, Precision and Transparency

“…While health literacy research has gained momentum in the global context [ 39 , 40 ], it is predominated by cross-sectional studies, with less than 8% of all published papers focusing on health literacy interventions, including randomized controlled trials [ 41 , 42 ]. Unlike time-series data, cross-sectional data make it impossible to make a valid statement regarding the change.…”

“…Figure 1 shows that there are substantial opportunities for researchers to generate specific recommendations between personal and social determinants and health literacy (i.e., upstream intervention levers), and between health literacy and health and social outcomes (i.e., downstream intervention levers). For example, the education sector is a critical platform for health literacy interventions, and education for health literacy is a fundamental process and outcome across the life course [ 40 ]. Precision evidence is needed, such as at which time point, at what dosage, and which delivery approach is likely to have the most significant impact on improving population health literacy and reducing health inequities.…”