An overview of health literacy for adult literacy practitioners
Jonathan Berry MA Jonathan Berry is the Director of the Community Health and Learning Foundation (CHLF). He has an extensive health background and has been the ContinYou's Executive Director for Health and Wellbeing for five years. Before that he was Head of Public Involvement for Rugby PCT. These roles were preceded by spells running a Community Health Council and as Director of the West Midlands Health Research Unit. An experienced strategic and project manager, Jonathan managed Phase 2 of the national Skilled for Health programme on behalf of the Department of Health and BIS which led him to develop a particular interest in health literacy and the links between learning and health inequalities. The CHLF specialises in delivering health literacy courses for people with low basic skills and health literacy training for the practitioners working with them.
Introduction This article aims to define health literacy in a manner which makes it accessible and meaningful for literacy practitioners. It outlines the impact that having lower levels of health literacy can have on people's health. It also discusses to what extent literacy practitioners can and do engage with the health literacy agenda and how they might do so in the future. It describes the national health literacy course, Skilled for Health, and examines how this might be of use to literacy practitioners.
This article is based on a workshop given by Jonathan Berry at the recent RAPAL annual conference held on the 5th April 2014 in Birmingham and on a guide to health literacy - a collaboration between the CHLF and NIACE. The latter will be published in the summer of 2014 and will cover the issues explored below in much greater detail.
What is health literacy? According to Nutbeam (2008), health literacy research has traditionally been generated by the clinical care paradigm or the health promotion paradigm. In the former, it is a basic skill, the lack of which constitutes a risk to the ability to achieve and maintain good health. Nielsen- Bohlman et al (2004) sees health literacy as a basic skill:
The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.
A wider view of health literacy is offered by the World Health Organisation (WHO). Here health literacy includes the ability to understand scientific concepts, content, and health research; skills in spoken, written, and online communication; critical interpretation of mass media messages; navigating complex systems of health care and governance; and knowledge and use of community capital and resources, as well as using cultural knowledge in health decision making. Within this construct, health literacy implies the achievement of a level of knowledge, personal skills and confidence to take action to improve personal and community health by changing personal lifestyles and living conditions. Thus, health literacy means more than being able to read pamphlets and make appointments. By improving people's access to health information, and their capacity to use it effectively, health literacy is critical to self-empowerment. In other words, health literacy facilitates sound health decisions in the context of everyday life: at home, in the community, at the workplace, in the health system, in the market place and in the political arena. This is significant for literacy practitioners because it means that health literacy sits very firmly in their domain (e.g. courses on healthy eating and other lifestyle and preventative measures) as well as in the medical domain (e.g. where patients are taught to self-manage a long term condition).
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