Health-Literate Youth: Evolving Challenges for Health Educators.

Across the country for the last several years, health literacy has become a "buzz word"--a major topic of discussion. In 2008, the American Association for Health Education approved a position statement on health literacy. (1) As a health educator since 1971 and after reading article after article about math literacy, reading literacy and science literacy, I think it's about time! Before delivering my AAHE Scholar Address in April 2010, a Google search for the words "health literacy" identified 5,120,000 and 988 videos. On June 30, 2010, a new Google search for "health literacy" identified 20,800,000 and 1,300 videos. Clearly, health literacy continues to be an important concern across the country. And, health educators in all settings acknowledge that health literacy is a key determinant of health outcomes, has a major impact on health disparities, and most important, should be a fundamental part of general education. Although it is important that all individuals become health-literate, my comments are focused on youth because most of my professional work has centered within school settings working with children and youth from ages 6-18 years. More important, I believe that is where we must begin, and the earlier, the better. Hopefully by beginning on the first day of kindergarten and continuing through high school graduation, we can make a difference. I believe health-literate youth will grow up to be health-literate adults who will be able to make positive health-related decisions for themselves and the parents/guardians for whom they likely will become primary caregivers. In my discussion, I will address what I see to be some evolving challenges for health educators working with youth as well as some possible strategies for addressing them. EVOLVING CHALLENGE #I : UNDERSTANDING HEALTH LITERACY "To begin with an end in mind means to start with a clear understanding of your destination." (2)(p98) Moreover, as Eleanor Roosevelt said, "Understanding is a two-way street" Before we, as health educators, can facilitate understanding of health literacy, we must truly understand it ourselves. So, what is health literacy? Does the meaning of health literacy vary from person to person, organization to organization and location to location? Why is health literacy important? What is implied when we say someone is health-literate? How does health literacy work? What are the potential benefits of health literacy and the potential consequences of not being health literate? To what other concepts are health literacy connected? How do we see health literacy in relation to our work in health education, health promotion, risk reduction, disease prevention and health care reform? Finally, how do we measure health literacy? What does a health-literate person know and what is a health-literate person able to do? Clearly, understanding (as a concept) is complex; it is much broader than mere knowledge. Moreover, there are many different ways of understanding. Like a die, understanding is multi-faceted? When one truly understands an idea or concept, he/she can explain it, can interpret it and can apply it; he/she has perspective, can empathize and has self-knowledge. (3) So, let us examine health literacy in each of its facets. Understanding Facet #1: Explanation. This first facet is basic--what is health literacy and what is it not? Initially, we must define health. On more than one occasion, when sharing my profession (i.e., health educator) with a person I did not know, the first question I was asked (focusing on the physical) is "Oh, what sport do you play?" Most professionally-prepared health educators agree that health is a dynamic process of achieving one's potential in several interrelated dimensions. In the literature and in multiple textbooks, health has been portrayed as a continuum, a star, a wheel, or one of many other geometric shapes. Regardless of the model used, when we talk about health literacy, we must not limit our discussions to physical health and accessing the (physical) health care system; we must remember to address all dimensions of health--physical, emotional, mental, social, and spiritual. …