What is Health Literacy?
We need to revisit definitions of terms for health literacy inquiry. A definition does, after all, shape research by suggesting a focus, determining the measures to be used, as well as specifying who or what is to be measured. If the definition of health literacy continues to focus on patients’/people’s skills, so too will the measures. Findings will be limited and could be faulty. We might ask: to what extent does the definition we use include the interactions among individuals, materials and messages designed and delivered by health professionals, and the norms, policies, and practices within institutions? In addition, we have to be sure that we measure each of these three realms. This perspective was reflected in the 2003 USDHHS and 2004 IOM documents:
‘Although the literacy and verbal skills of individuals are of critical importance, so too are the demands made by the health materials themselves, the communication skills of those in the health field, and the complicated nature of the healthcare and public health systems.’ Rima Rudd, Objective 11-2: Improvement of Health Literacy in Communicating Health, USDHHS, 2003
‘Health literacy is a shared function of social and individual factors. Individuals’ health literacy skills and capacities are mediated by their education, culture, and language. Equally important are the communication and assessment skills of the people with whom individuals interact regarding health, as well as the ability of the media, the marketplace, and government agencies to provide health information in a manner appropriate to the audience.’ Health Literacy: A Prescription to End Confusion, The Institute of Medicine, 2004
Don Nutbeam, who first defined health literacy for the WHO Health Promotion Glossary in 1998, noted many years later that health literacy is an evolving concept. For a more detailed discussion of definitions click on the following: