The evolving concept of health literacy☆
Section snippets
Literacy and health
Poor literacy skills among adults are surprisingly common in developed countries. Estimates of the proportion of the population in individual Organisation for Economic Co-operation and Development (OECD) countries lacking functional literacy skills range from 7% to 47% (UN Development Program, 2007). In developing countries these figures are far higher. Though there is a range of definitions of functional literacy, most focus on the ability to read basic text and write a simple statement on
Health literacy as a risk factor
The growing awareness of the relationship between literacy and health has led to a range of responses to mitigate the negative effects. This interest is observable in research into the measurement of health-related literacy, examination of the relationship between low literacy and a range of health conditions, and progressive testing of interventions designed to mitigate the effects of low literacy through modified communications, and improved service organization (Coulter and Ellins, 2007,
The measurement of health literacy
The different definitions of health literacy imply that different measurement tools are developed. In the US the TOFLA and REALM measures have been tested, refined and validated over time to provide short screening tools for clinicians to use in everyday practice with a broad range of populations, including, for example, with adolescents (Chisolm & Buchanan, 2007). As indicated above, Baker expresses concern that neither is comprehensive, measuring only selective domains that are thought to be
Where to from here?
The two conceptualizations are similar in some respects but distinctly different in others. Both are dependent on the underlying base of literacy and numeracy, and are context and setting specific. In the asset model, health literacy is a distinct concept, an outcome to health and patient education. In the risk model health literacy is a “prior status” derived from existing literacy and numeracy. In the asset model, health education is directed towards enabling individuals to exert greater
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The following individuals have commented on this paper. Irving Rootman, Kirsten McCaffery, Sian Smith, and Gillian Rowlands.