the basics - World Health Communication Associates

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4.4 HOME AND COMMUNITY SETTINGSPeople are called upon to make daily health-related decisions in their homes andcommunities. Families, friends, peers and community resources are key sourcesof health information. These sources model behaviours and shape the early andcontinuing development of functional health literacy skills related to product andservice choices. They also provide basic information about health-promoting, healthprotectingand disease-preventing behaviours, as well as self- and family care,‘alternative therapies’, available support services and first aid.4.4.1 ChallengesChronic diseasesAccording to WHO (cited in Pruitt & Epping-Jordan 2005), chronic diseases—forexample diabetes, emphysema, heart disease and cancer—currently account formore than half of the global disease burden in both developed and developingcountries. People with chronic diseases have more health literacy demands, such asthe need for self management (see below), the need to coordinate care with multipleproviders and the ability to manage multiple, lifelong prescription medications. Thesepeople, however, often have poorer health literacy skills.Patients with chronic diseases and limited health literacy have been shown tohave poor knowledge of their condition and of its management. They also experiencedifficulties with oral communication. A study of patients with diabetes found thatpoor health literacy was associated with worse blood sugar control and higher ratesof complications such as retinopathy, blindness, heart disease and strokes (Schillingeret al. 2004; Williams et al. 1998a, 1998b).WHO and several international health professional associations have called formajor changes in health workforce training to develop the provider skills required tomeet the health literacy and other needs created by the prevalence of chronic illness.Skills called for include the ability of providers to support self-managed care, buildmore partnership-based provider–patient relationships and communicate moreeffectively (Pruitt & Epping-Jordan 2005).Self managementIn the past, patient health management was primarily the physician’s responsibility.However, in many health systems people are increasingly encouraged to take moreresponsibility for their own health. To make appropriate self-management decisions,50SECTION 4: WHAT CAN WE DO TO STRENGTHEN HEALTH LITERACY?
people must locate health information, evaluate the information for credibilityand quality and analyse risks and benefits. Furthermore, people must be able askpertinent questions and express health concerns clearly by describing symptoms inways the providers can understand (IOM 2004).Moreover, people are increasingly challenged to make sound health decisionsin many contexts of daily life. For example, they have to read and understand productlabels and warnings; make lifestyle choices about food, activity, cigarettes and drugs;and evaluate the safety of chemicals in products they buy. Such decision makingrequires an understanding of the benefits of being healthy and information aboutpersonal health issues. All of these everyday demands require people to be ableto assess their current health and consider and deal with the many socioeconomicfactors and cultural values that influence it. For all this they need to have healthliteracy competencies that allow them to take responsibility for their own and theirfamily’s—and, where necessary, their community’s—health (Kickbusch & Maag2008).Finally, many people use alternative therapies. This includes traditional healingapproaches, nutritional supplements, acupuncture, homeopathy and a wide varietyof other therapeutic and healing techniques. The estimated global market for suchinterventions equals or exceeds allopathic health care markets in many countries.The need to make choices between alternative approaches and standard medical carecreates further challenges.Community participationCommunity participation aims to identify, shape and advance shared interests inpriority issues for community health. This might be investment in education forself-care, increased penetration of vaccinations, elimination of vectors and control ofsexually transmitted diseases. Investment in such participatory health literacy skilldevelopment can help individuals use systems more effectively and also serve ascatalysts for change, when needed, within systems (IOM 2004).SECTION 4: WHAT CAN WE DO TO STRENGTHEN HEALTH LITERACY? 51
Page 2 and 3: 2 FOREWORD
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Page 9 and 10: The guide has been developed throug
Page 11 and 12: WHO IS THIS GUIDE FOR?SUMMARYHealth
Page 13 and 14: Section 5: How can we advocate for
Page 15 and 16: systems and settings are ones which
Page 17 and 18: companies—which glamorise and pro
Page 19: Health literacy is best viewed as a
Page 22 and 23: 3. POOR HEALTH LITERACY IS ASSOCIAT
Page 24 and 25: Percent Alive50 60 70 80 90 100Adeq
Page 26 and 27: • Written communication regarding
Page 28 and 29: 3.2 MEASURING THE DEMAND AND COMPLE
Page 30 and 31: 3.3 SCORECARDSThe WHCA Action Guide
Page 32 and 33: 3.4 A PUBLIC HEALTH LITERACY KNOWLE
Page 34 and 35: Social CapitalLinks have also been
Page 36 and 37: They also have to move from communi
Page 38 and 39: Use active voiceAvoid unnecessaryja
Page 40 and 41: epidemic outbreak tracking (providi
Page 42 and 43: may also include direct instruction
Page 46 and 47: For example, children and young peo
Page 48 and 49: Initiatives which have been shown t
Page 50 and 51: · understanding of bias and levels
Page 54 and 55: 4.5 WORKPLACE SETTINGSThe workplace
Page 56: 4.6 POLICY-MAKING ARENASPolicies at
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Page 63 and 64: REFERENCESAllen CE. 2001. 2000 pres
Page 65 and 66: Figueroa ME, Kincaid DL, Rani M & L
Page 67 and 68: Kickbusch I & Maag D. 2008. Health
Page 69 and 70: Parker RM, Ratzan, SC & Lurie N. 20
Page 71: Sudore RL, Yaffe K, Satterfield S,
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