School of Interdisciplinary Health Programs, Western Michigan University, Kalamazoo, MI 49001, USA.
Interdisciplinary Centre for Health Literacy Research, Bielefeld University, 33615 Bielefeld, Germany.
Int J Environ Res Public Health. 2020 Feb 24;17(4):1436. doi: 10.3390/ijerph17041436.
In many countries, health literacy research, practice, and policy have been moving away from a focus only on medical care and health-care settings to a much broader conceptualization. In this broader perspective, health literacy can be obtained and used across many other settings (e.g., school, home, workplaces, government) towards achieving health and wellness goals across the life-course for individuals, families, and communities. The education sector is a critical domain towards these achievements and is a fundamental process and outcome. This can help towards important public health goals, including critical health literacy, as oriented not only towards individual actions, but also towards supporting effective social and political action. This Perspective Article describes the importance and utility of the perspective, which, follows a view that health literacy is a from which improved population health, health promotion and disease prevention could be achieved across diverse contexts. We first describe different educational paradigms to address health literacy and clarify the perspective as a supportive, instructional and capacity-building global resource across the life-course. Then, using specific examples from Canada, America, and Germany, we provide a snapshot of the diverse ways in which the perspective can be found in national policies. These include broad national goals and standards (Germany and Canada) and major health care reform (America). We next consider the tensions and gaps that can arise in the translation and implementation of these policies relative to the ideal education for health literacy perspective, especially related to equity. These include the need for funding, goals of the educational system, and limited evaluation of policy in practice. Finally, we highlight strategic opportunities to achieve education for health literacy and equity especially offering examples from innovative practice in Canada across the lifespan.
在许多国家，健康素养研究、实践和政策已经不再仅仅关注医疗保健和医疗环境，而是转向更广泛的概念。在这个更广泛的视角下，健康素养可以在许多其他环境中获得和使用，例如学校、家庭、工作场所、政府，以实现个人、家庭和社区整个生命周期的健康和幸福目标。教育部门是实现这些目标的关键领域，是一个基本的过程和结果。这有助于实现重要的公共卫生目标，包括关键的健康素养，不仅关注个人行动，还支持有效的社会和政治行动。本文观点描述了这一视角的重要性和实用性，该视角认为健康素养是一种方法，通过这种方法可以在不同的背景下实现改善人口健康、促进健康和预防疾病的目标。我们首先描述了不同的教育范式来解决健康素养问题，并澄清了健康素养视角作为一种支持性、指导性和能力建设的全球资源，贯穿整个生命周期。然后，我们使用来自加拿大、美国和德国的具体例子，展示了在国家政策中可以找到的健康素养视角的多样性。这些例子包括广泛的国家目标和标准（德国和加拿大）以及重大的医疗保健改革（美国）。接下来，我们考虑了在翻译和实施这些政策时可能出现的紧张局势和差距，特别是与健康素养教育的理想情况相比，这些差距与公平有关。其中包括资金需求、教育系统的目标以及对实践中政策的有限评估。最后，我们强调了实现健康素养和公平教育的战略机遇，特别是提供了加拿大在整个生命周期内创新实践的例子。
