Lunze Karsten, Paasche-Orlow Michael K
a Boston University School of Medicine , Boston , Massachusetts , USA.
J Health Commun. 2014;19 Suppl 2:15-8. doi: 10.1080/10810730.2014.946115.
The Organization for Economic Cooperation and Development (OECD) implemented the Program for the International Assessment of Adult Competencies (PIAAC) to provide policymakers with nationally representative profiles of knowledge, skills, and competencies. Results among participating countries indicate that the United States and Germany stand out as having the strongest relationship between literacy skills and self-reported health. Our analysis addresses factors that could mediate the particularly strong link between low literacy and poor health in these two countries and possible remedies for the problem. In particular, PIACC results also reveal that the United States and Germany share the most entrenched multigenerational literacy problem among the countries in the PIAAC survey. In spite of the many social differences that currently distinguish Germany and the United States, these countries share the lowest level of social mobility for education. Promoting social mobility by making higher education more accessible for those whose parents did not have the chance to access it might thus not only promote literacy and social capital, but indirectly also promote public health. Given the PIACC findings, the concept of social mobility and opportunities to dissolve the educational stratification merit more attention in public health research.
经济合作与发展组织（OECD）实施了成人能力国际评估项目（PIAAC），以便为政策制定者提供具有全国代表性的知识、技能和能力概况。参与国的结果表明，美国和德国在读写能力与自我报告的健康状况之间的关系最为显著。我们的分析探讨了可能调节这两个国家低读写能力与健康状况不佳之间特别紧密联系的因素以及该问题的可能补救措施。特别是，PIACC的结果还显示，在美国和德国在PIAAC调查的国家中存在最根深蒂固的多代读写问题。尽管目前德国和美国存在诸多社会差异，但这两个国家在教育方面的社会流动性水平最低。因此，通过使那些父母没有机会接受高等教育的人更容易接受高等教育来促进社会流动性，可能不仅会促进读写能力和社会资本，还会间接促进公众健康。鉴于PIACC的研究结果，社会流动性概念以及消除教育分层的机会在公共卫生研究中值得更多关注。
