Health literacy has received great attention as a risk factor or as an asset for health as well as being a powerful mediator of the social determinants of health (Nutbeam, 2008; Kickbusch et al, 2013). Whereas the aspect of mediating social determinants is quite familiar in the recent health literacy discussion, the question of how health literacy itself is mediated, and especially by social environments, is far less the focus of attention. It is helpful, however, that health literacy has already been described as a ‘complex social construct’, which refers to a phenomenon that is not directly observable but shaped by the way it is socially practised (Pleasant, 2014).
Social practice can be seen as an indicator of direction for further debates concerning the conditioning of the social factors of health literacy (see Chapters 36 and 39, this volume). Using social embeddedness as a superior concept, this term encompasses social factors in general and the interplay of compositional and contextual factors in particular (groups, social milieus and material environments). Interestingly, the integrated health literacy definition by Sørensen et al (2012, p 3) highlights ‘people’s knowledge, motivation and competences to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve quality of life during the life course’, but does not include a wider perspective concerning non-individual factors. Despite the fact that there are heterogeneous health literacy concepts available focusing not only on the knowledge and abilities of the individual but also on the relatedness of health literacy to the individual and communities’ socioeconomic and socio-cultural context (Parker and Ratzan, 2010; Kickbusch et al, 2013; Sørensen et al, 2015; see also Chapter 18, this volume), the importance of the discussion on social embeddedness has not yet been fully captured.
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.
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.