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  • Author or Editor: Diane Levin-Zamir x
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Health literacy (HL) is crucial to health as it is associated with a variety of health behaviours and a predictor of many health outcomes (Berkman et al, 2010; Paasche-Orlow and Wolf, 2010; Levin-Zamir et al, 2016). HL is not evenly distributed within the population or across the lifespan. Groups at risk for low HL include people with limited financial resources, members of minority ethnic groups – especially those with a mother tongue other than the local language – people with low educational attainment and older people (Nielsen-Bohlman et al, 2004; Vernon et al, 2007; ABS, 2008; Ng et al, 2014; Sørensen et al, 2015). In a highly media-saturated and digitalised world, health information is increasingly available and accessed via diverse media. The skills to navigate this environment are strongly linked to HL, and as such are not equally distributed within the population. This chapter presents two constructs – media health literacy (MHL) and eHealth literacy (eHL) – and offers an overview of their associations with health behaviour both across different age groups and among special populations. Interventions to improve MHL and eHL are discussed, and conclusions for further research on health literacy and health behaviour in the digital era drawn.

MHL (Levin-Zamir et al, 2011) is based on the foundations of health literacy and media literacy. The concept builds on the premise that unlike health content and information intentionally generated by the health system, mass media content is often implicit and can be either health promoting or health compromising. Based on the components of the Nutbeam model of HL (Nutbeam, 2000; see also Chapter 14, this volume), MHL is conceptualised as a continuum, ranging from the ability to identify health-related content (explicit and/or implicit) in the media; recognise its influence on health behaviour (comparable to functional HL); critically analyse the content (comparable to critical HL; see Chapter 11, this volume); and express intention to respond through action (personal health behaviour or advocacy) (comparable to interactive HL).

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Research, Practice and Policy across the Life-Span

Available Open Access under CC-BY-NC licence. Health literacy addresses a range of social dimensions of health, including knowledge, navigation and communication, as well as individual and organizational skills for accessing, understanding, evaluating and using information. Particularly over the past decade, health literacy has globally become a major public health concern as an asset for promoting health, wellbeing and sustainable development.

This comprehensive handbook provides an invaluable overview of current international thinking about health literacy, highlighting cutting edge research, policy and practice in the field. With a diverse team of contributors, the book addresses health literacy across the life-span and offers insights from different populations and settings. Providing a wide range of major findings, the book outlines current discourse in the field and examines necessary future dialogues and new perspectives.

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Chronic conditions (otherwise known as long-term health conditions) have been defined as ‘illnesses that are prolonged in duration, do not often resolve spontaneously, and are rarely cured completely’, and which are managed with medication and other treatments (Department of Health and Social Care, 2012). As medical advances and improved healthcare have transformed many life-threatening, acute medical conditions such as cancer, diabetes and acquired immune deficiency syndrome (AIDS) into chronic lifelong conditions, the number of patients suffering from one or more chronic conditions is expanding – chronic diseases account for 86 per cent of the deaths and 77 per cent of the disease burden in Europe (WHO, 2015). And the issue is global: 80 per cent of premature deaths due to chronic diseases occur in developing countries according to data from 2009 (WHO, 2015).

The increasing prevalence of chronic conditions that is currently found in children becomes even more disturbing when considering that its prevalence increases through the life course, peaking among older people. In the UK, 58 per cent of people aged over 60 now have a chronic condition compared to 14 per cent in younger adults. People are increasingly suffering from more than one chronic condition simultaneously (multi-morbidity) (Department of Health and Social Care, 2012). Chronic diseases also have an impact on economies – treatment and care is estimated to take up around £7 in every £10 of total health and social care expenditure in the UK according to data from 2009 (Department of Health and Social Care, 2012).

The aim of this chapter is to explore the associations between chronic conditions and health literacy, both from the perspective of patients and citizens (a crosssectional view), and through people’s life journey from childhood through to adulthood and old age (a longitudinal view).

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Health literacy has recently become a topic of relevance among researchers, practitioners and policy-makers across various disciplines. One major driver of this obvious increase in importance is the potential that has been attributed to health literacy in order to understand, explain and tackle individual as well as group differences in various health outcomes. Empirical findings such as the results from the European Health Literacy Project have supported such perspectives as they have consistently been highlighting the need for action. The emergence of the topic of health literacy in various research and policy agendas has also been promoted by the zeitgeist prevailing in Western societies that is also rising in other parts of the world.

Concepts of health literacy basically address the use of health information in all forms and thus fit well as an approach to cope with the various challenges that Western societies have recently been faced with. The rise of digital technologies, for example, has been associated with a sharp increase in the multimodal availability of, and a simplified access to, information and data. Citizens and consumers are therefore challenged by the overwhelming supply of information in various ways. Other key words such as ‘shared/informed decision-making’ or ‘patient empowerment’ point to the ongoing transition in the notion of the bond between the doctor and the patient. The questioning of interaction patterns and power relationships between experts and laypeople, as well as the shift in the assignment of responsibilities to laypeople, is not only restricted to healthcare but also applies to other areas of life – or, in other words, to everyday life where people live, work, study and play.

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