Department of Sociology, Western Washington University, 516 High Street, Bellingham, WA 98225, USA.
Health Promot Int. 2011 Mar;26(1):4-13. doi: 10.1093/heapro/daq049. Epub 2010 Aug 20.
In spite of improvements in global health over the 20th century, health inequities are increasing. Mounting evidence suggests that reducing health inequities requires taking action on the social determinants of health (SDOH), which include income, education, employment, political empowerment and other factors. This paper introduces an alternative health education curriculum, developed by the US-based non-profit organization Just Health Action, which teaches critical health literacy as a step towards empowering people to achieve health equity. Critical health literacy is defined as an individual's understanding of the SDOH combined with the skills to take action at both the individual and the community level. Prior to describing our curricular framework, we connect the recommendations of the World Health Organization Commission on the SDOH with the objectives of the Ottawa Charter for Health Promotion by arguing that achieving them is reliant on critical health literacy. Then we describe our four-part curricular framework for teaching critical health literacy. Part 1, Knowledge, focuses on teaching the SDOH and the paradigm of health as a human right. Part 2, Compass, refers to activities that help students find their own direction as a social change agent. Part 3, Skills, refers to teaching specific advocacy tools and strategies. Part 4, Action, refers to the development and implementation of an action intended to increase health equity by addressing the SDOH. We describe activities that we use to motivate, engage and empower students to take action on the SDOH and provide examples of advocacy skills students have learned and actions they have implemented.
尽管 20 世纪全球卫生状况有所改善，但健康不平等现象却在加剧。越来越多的证据表明，要减少健康不平等，就必须针对健康的社会决定因素（SDOH）采取行动，其中包括收入、教育、就业、政治赋权和其他因素。本文介绍了一种由美国非营利组织“公正健康行动”（Just Health Action）开发的替代健康教育课程，该课程将批判性健康素养作为赋予人们实现健康公平权力的一种手段。批判性健康素养被定义为个人对 SDOH 的理解，以及在个人和社区层面采取行动的技能。在描述我们的课程框架之前，我们将世界卫生组织社会决定因素委员会的建议与《渥太华健康促进宪章》的目标联系起来，认为实现这些目标依赖于批判性健康素养。然后，我们描述了我们教授批判性健康素养的四部分课程框架。第一部分“知识”侧重于教授 SDOH 和健康作为一项人权的理念。第二部分“指南针”是指帮助学生找到自己作为社会变革推动者的方向的活动。第三部分“技能”是指教授具体的倡导工具和策略。第四部分“行动”是指通过解决 SDOH 来制定和实施旨在增加健康公平的行动。我们描述了我们用来激励、参与和授权学生对 SDOH 采取行动的活动，并提供了学生所学的倡导技能和实施的行动的例子。
