Health literacy refers to a person’s ability to use information and services for health. (More definitions)
Using information for health implies three steps:
1) Understanding, that is, decoding the words
2) Making personal meaning, that is, reflecting on the question: What does this mean for me in my situation with my resources, my family, my beliefs, my values?
3) Acting, that is, making choices and turning those choices into desired actions and health outcomes.
These steps coincide with three steps in problem solving,
which I’ve described previously as The Three-Step Dance:
1) What do you want? For example, a woman decodes information in Beginnings Pregnancy Guide. She understands smoking can harm an unborn baby.
2) What have you got? She acknowledges that she has a pregnancy, and a smoking habit that she enjoys and that relieves stress. She has a husband who smokes and a mother-in-law who smoked through her pregnancy and has a son who turned out fine. She has a budget already stretched, a friend who’s been after her to quit, and a doctor who’s offered some aids. Through self-reflection and discussion with family, friends, experts she makes personal meaning from the information.
3) What’s Next? She makes a choice (decision) not to act or to take action — some small step that she is willing and able to do now to move toward her chosen outcome — a healthy baby, which she understands requires a smoke-free womb.
It is the action (or inaction) that affects the outcome.
The first two steps in using information for health, and in addressing a health problem, are “all in your head”, a purely cognitive exercise with no health effects.
What’s empowerment got to do with it?
Take another look at Step 3 in using information for health: making choices and turning those choices into desired actions and health outcomes. This is the World Bank’s definition of empowerment. And the “Three-Step Dance” is the process of empowerment described by David Emerald in his book The Power of TED* The Empowerment Dynamic.
Empowerment is the act-ive ingredient in health literacy. Without it, it’s all in your head.
“Knowing is not enough; we must apply. Willing is not enough; we must do.” ~Goethe
Note the Goethe quote is typically featured in the front matter of reports from the Academy of Medicine (formerly the Institute of Medicine). It is often attributed to Bruce Lee, but Goethe said it first)
Alsop, R. & Heinsohn, N. (2005) Measuring Empowerment in Practice : Structuring Analysis and Framing Indicators. World Bank. Free online: https://openknowledge.worldbank.org/handle/10986/8856
The Power of TED by David Emerald - YouTube https://www.youtube.com/watch?v=t5hSa16FX94