Critical Health Literacy

Author:

Sykes Susie,Abel Thomas

Abstract

Inequalities in health, or the systematic difference in health status across different population groups and communities, persist globally and are, in some cases, increasing. While some inequalities are linked to behavior, the majority are attributable to social, economic, and environmental factors, often referred to as the social determinants of health. Strategies to address the determinants of health have been central to public health and health promotion (see Oxford Bibliographies in Public Health article “Health Promotion” by Lawrence Green) for several decades and are enshrined in the Ottawa Charter (see Oxford Bibliographies in Module article “Ottawa Charter” by Evelyne De Leeuw). Understanding the structure and agency processes that determine the production and distribution of health is fundamental to all levels of public health action and a requirement for active citizenship with regard to health. More recently health literacy (HL) (see Oxford Bibliographies in Module article “Health Literacy” by Rima Rudd and Lisa Schubiner) has been suggested as an approach to tackle inequalities in health and does so with a focus on empowerment through informed health behaviors of individuals and on health literacy–friendly environments such as health care settings. This focus risks neglecting issues of agency and change at the structural level required to impact on determinants of health. The current public health landscape presents new and growing challenges such as pandemics, climate change, unprecedented displacement and migration, and commercial determinants of health including unsustainable practices of production and trade. This comes at a time when people have access to a burdensome excess of information, misinformation, and disinformation (often referred to as an infodemic). There is also a growing skepticism and lack of trust in scientific and political sources, and in an evidence base that can change quickly such as during the COVID-19 pandemic. Within this context, critical health literacy (CHL) with its focus on individual and community understanding, reflection, and equitable agency for change at a structural level may offer a potential approach that provides opportunities to tackle inequalities of health. The following bibliography presents key publications which explore conceptualizations of CHL, its theoretical foundations, how it might be measured, and work done to support interventions for the development of CHL. We would like to thank Richard Benkert and Catherine Jenkins for their contribution to the literature search in the development of this article.

Publisher

Oxford University Press

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