The starting point – health
The focus of health literacy – "Gesundheitskompetenz" in German – is based on health, as demonstrated by its involvement in the concept of health-literate healthcare organisations (Konzept Gesundheitskompetenter Krankenbehandlungsorganisationen). Jürgen M. Pelikan, who jointly developed this concept, outlined health literacy as follows at the meeting of the Carinthia University of Applied Sciences in 2014 (Tagung der Fachhochschule Kärnten 2014): "Health literacy (HL) first appeared as a concept in 1974 and since then has had remarkable coverage through the health sciences, health care research, public health and health promotions […]. HL is the fruit of literacy research and therefore has a long tradition in measuring competence in the health sciences."
The educational aspect
The education aspect is more noticeable, at least in German terminology: "In German-speaking countries, the health literacy concept is replaced by terms such as 'Gesundheitsalphabetisierung', 'Gesundheitsbildung', 'Gesundheitsmündigkeit' or 'Gesundheitskompetenz'," explain Holger Penz, Hannes Martinz, Regina Klein and Karl Krajic. The primary focus is on information handling. On the one hand, how can we ensure that individuals are able to understand health-related information and, on the other hand, how can we guarantee that health system representatives communicate information in an understandable manner?
Health literacy of health professionals
Health professionals can contribute to health literacy, not only by communicating clearly but also by improving their literacy skills. The Women's Health Centre in Graz (Frauengesundheitszentrum Graz) notes that "health professionals are often unaware of the benefits of screening, which explains why the general public are sometimes misinformed". From their survey of numerical understanding and the risk literacy of health professionals in Austria, Nicole Jakob and Martin Sprenger recognise the need for action in the education and continuing education of health professionals.
Equal opportunities and self-determination in health matters
The Austrian health literacy platform (Österreichische Plattform für Gesundheitskompetenz) focuses closely on the information aspect, but goes beyond this: "Health literacy is an important cornerstone of health and equal health-related opportunities for everyone living in Austria. It should help the population to make personal decisions that contribute to a healthy lifestyle on a daily basis." The terms "equal opportunities" and "self-determined" are intrinsically linked with adult education.
The capability approach goes beyond the skill-orientated approaches to health literacy that have been outlined. Capacity building was developed back in the 1980s by Amartya Sen and Martha C. Nussbaum. According to this approach, a fair society can be recognised by its ability to enable individuals to develop skills not only through individual advancement but also by creating framework conditions conducive to the development of skills, including the ability to lead a healthy life.
The first European Health Literacy Survey (HLS-EU) was carried out in eight European countries in the summer of 2011. The study found that the Austrians who were interviewed rated their health literacy as significantly worse than respondents in other countries. A correlation between health literacy and education was established. The study concludes that "people who are socially disadvantaged and less educated as well as older, chronically sick patients can benefit from supporting framework measures to a particularly high extent."
Further surveys will follow. Peter Nowak from Gesundheit Österreich GmbH explains: "A new population survey is in the pipeline as part of the Austrian health care reform, 'Zielsteuerung Gesundheit'. In 2018, an internationally approved survey will be prepared under the auspices of WHO/Europe. This will be carried out in 2019 and results are expected in early 2020."
The approaches to the topic of health literacy outlined here have found their way into Austrian adult education practices in many guises. Another blog post gives practical examples and identifies vulnerable groups that are difficult to reach with health literacy programmes.
More information in German:
- Gesundheitskompetenz: Definition der Österreichischen Plattform Gesundheitskompetenz
- Gesundheitskompetenz: Information des Bundesministeriums für Gesundheit und Frauen (BMGF)
- Health Literacy Survey 2016
- Empfehlungen für eine international vergleichbare Erhebung von Gesundheitskompetenz in Österreich (PDF)
- Health Literacy als Basiskompetenz (in) der Gesundheitsgesellschaft: Tagungsband des Kongresses der Österreichischen, Deutschen und Schweizer Fachgesellschaften für Gesundheits- und Medizinsoziologie, September 2014 (PDF)
- Christina Dietscher und Jürgen M. Pelikan: Gesundheitskompetente Krankenbehandlungsorganisationen – Ergebnisse der Machbarkeitsstudie (PDF)
- Angebote zur Förderung von Gesundheitskompetenz in Österreich (PDF)
Jürgen M. Pelikan (2014): „Gesundheitskompetenz in der Gesundheitsgesellschaft – eine Herausforderung für Gesundheitswissenschaften, Gesundheitsförderung und die Soziologie“ In: Holger Penz, Hannes Martinz, Regina Klein, Karl Krajic: Tagungsband Health Literacy als Basiskompetenz (in) der Gesundheitsgesellschaft. Fachhochschule Kärnten 2014, S. 31-36.
Nicole Jakob und Martin Sprenger (2014): Erhebung des Zahlenverständnisses sowie der Risk Literacy von Health Professionals in Österreich. In: Holger Penz, Hannes Martinz, Regina Klein, Karl Krajic: Tagungsband Health Literacy als Basiskompetenz (in) der Gesundheitsgesellschaft. Fachhochschule Kärnten 2014, S. 153-156.
Michael Tetzer (2014): Befähigt sein, ein gutes Leben führen zu können. In: Holger Penz, Hannes Martinz, Regina Klein, Karl Krajic: Tagungsband Health Literacy als Basiskompetenz (in) der Gesundheitsgesellschaft. Fachhochschule Kärnten 2014, S. 29-30.
Text/Author of original article in German: Otto Rath/CONEDU
Redaktion/Editing: Karin Kulmer/CONEDU