Reprinted from the "Health Literacy" issue of Visions Journal, 2013, 8 (2), pp. 7-8
“Literacy” is your ability to read, write, understand and apply the materials. “Health literacy” is an extension of literacy—the “skills to enable access, understanding, and use of information for health.”1
An example of health literacy is following your doctor’s instructions when you receive a prescription medication. It may seem simple, but it may take quite a lot of information to achieve this task. First, you’ll need to understand your doctor or pharmacist’s instructions and read any patient information sheets that are included with your medication. You’ll also need to understand why you need the medication, what might happen if you don’t take the medication, and what risks may go along with the medication. All of these questions may influence your decision to take (or not take) the medication, which in turn may affect your overall health.
The general concepts described here can also be applied to “mental health literacy.” Mental health literacy simply refers to health literacy that is specific to your knowledge about mental illnesses.2
Health literacy and health promotion
Health literacy and health promotion are two different but highly related ideas. Health promotion is promotion or encouragement to take care of your health. Promotion is proactive—you take action to promote a positive goal. It might mean eating well and getting enough sleep because you feel healthier rather than to reduce the risk of catching a cold. Health literacy is a tool for health promotion. In order to make an informed decision about your health, you have to start at the beginning: you have to know what you want to achieve. Within the context of health promotion, increasing health literacy may be reflected in activities like proactive workplace health policies. In this situation, the goal is to understand positive health and how you might protect and increase health and well-being.
Promotion versus prevention
Health promotion is proactive and encourages you to take steps that improve your health. Prevention strategies, on the other hand, encourage you to take action to prevent or reduce the risk of a health problem. A simple example is washing your hands often when someone around you is sick to reduce the risk of becoming sick. From a prevention point of view, increasing health literacy may be reflected in activities like early recognition of a problem and early treatment. It may also include identifying groups who experience increased risk factors and providing extra services or supports. In these situations, the goal is to understand mental disorders and take actions that reduce the effects of mental disorders.
Consequences of lower health literacy
Lower health literacy can be linked to the burden upon the health care system. When people aren’t aware of how they may handle a health concern or what kinds of supports are available, they may be more likely to depend on the health care system and demand services or procedures that aren’t necessary in their situation. If people believe that only a professional (like a psychologist or psychiatrist) can help, they may exclude other forms of support like self-help, social support or paraprofessionals. The demand for services often exceeds the available resources, so professionals have to allocate scarce resources most effectively.2
Critical perspectives of health literacy
Health literacy is not restricted to a particular set of beliefs or values, though the beliefs and values associated with the health care system may seem to be the dominant message for many people. Conflicting perspectives can create friction, such as the two following examples.
Top-down research versus experiences and perspectives
Health literacy generally depends on the work of experts like researchers and doctors. These experts may rely on data collected through methods like randomized clinical trials and large sample sizes. It’s a top-down system because a small number of people pass their interpretation of certain data to the rest of the population. It generally relies on the belief that people will adopt the findings because they are supported by sound research methods and evidence. However, research methods may not capture individual experiences. If someone’s experiences are labelled a ‘problem’ and this doesn’t align with their own interpretation of the problem or concern, they may be less willing to seek help or advice.2
Tensions between research and communities can also come up when the community doesn’t have the resources to follow the researcher’s suggested best practices. This situation can be seen around Aboriginal communities in Canada who rely on fish or wildlife that has been contaminated by pollution. While most people would likely agree that high levels of mercury can affect brain health and that avoiding fish from contaminated lakes and rivers may reduce the effects on contamination in people, it might not be a realistic solution. The people in those communities may rely on fishing because they don’t have the resources to buy outside food products.3
Individual responsibility versus social determinants of health
Mental health literacy work and the mental health care system in general is often criticized for “individualizing” mental health problems—that is, they may place the responsibility of following a treatment thought to be a ‘best practice’ on the individual. However, the health problem may be related to factors that the individual can’t control.
Mental health is influenced by many factors outside of the individual, such as income and distribution of wealth, availability of decent housing, social and community supports, and experiences of inclusion or exclusion. However, discord between individual responsibility and outside factors of health can create tensions. Here is an example: a person has a very low income and, despite their efforts, hasn’t been able to find a higher-paying job. Their experiences of hopelessness lead to the label of “depression.” Medication and talk therapy are considered the best practice in treatment of depression, and that person is told that they must follow this treatment plan. However, the treatments don’t change income levels or job availability.4
About the authorStephanie is the Editorial Coordinator for Visions
- Canadian Council on Learning. (2008). Health Literacy in Canada: A healthy understanding. Ottawa, ON: Author. www.ccl-cca.ca/ccl/Reports/HealthLiteracy.html.
- Jorm, A.F. (2000). Mental Health Literacy: Public knowledge and beliefs about mental disorders. British Journal of Psychiatry, 177, 396-401
- Bernard, Dickens M. (2011). The Role of Public Health in Mental Health. Journal of Ethics in Mental Health, 6. www.jemh.ca/issues/v6/documents/JEMH_Vol6_Kelowna-Article_Role_of_Public_Health.pdf.
- Friedli, L. (2009). Mental Health, Resilience and Inequalities. Copenhagen, Denmark: World Health Organization Regional Office for Europe. www.euro.who.int/__data/assets/pdf_file/0012/100821/E92227.pdf.