Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century

Health literacy is a relatively new concept in health promotion. Ir is a co mposite term to describe a range of outcomes to health education and commun ication activities From this perspective, health education is directed rewa rds improving health literacy. This paper identifies the failings of past e ducational programs to address social and economic determinants of health, and traces the subsequent reduction in the role of health education in cont emporary health promotion. These perceived failings may have led to signifi cant underestimation of the potential role of health education in addressin g the social determinants of health. A 'health outcome model' is presented. This model highlights health literacy as a key outcome from health educati on. Examination of the concept of health literacy identifies distinctions b etween functional health literacy, interactive health literacy and critical health literacy. Through this analysis, improving health literacy meant mo re than transmitting information, and developing skills to be able to read pamphlets and successfully make appointments. By improving people's access to health information and their capacity to use it effectively, it is argue d that improved health literacy is critical to empowerment The implications for the content and method of contemporary health education and communicat ion are then considered. Emphasis is given to more personal forms of commun ication, and community-based educational outreach, as well as the political content of health education, focussed on better equipping people to overco me structural barriers to health.