Takahiro Kiuchi1), Takeo Nakayama2), Hirono Ishikawa3), Tsuyoshi Okuhara1), Kazuhiro Nakayama4), Hiroki Sugimori5), Daisuke Son6), Seiji Yasumura7), Chikako Yamaki8), Yasumasa Eguchi9), Hiroshi Fukuda10)
1)Department of Health Communication, Graduate School of Medicine, The University of Tokyo, 2)Department of Health Informatics, Graduate School of Medicine, Kyoto University, 3)Teikyo University Graduate School of Public Health, 4) Graduate School of Nursing Science, St. Luke's International University, 5) Department of Nursing, Faculty of Sports and Health Science, Daito Bunka University, 6) Department of Community-based Family Medicine, Faculty of Medicine, Tottori University, 7)Department of Public Health, Fukushima Medical University School of Medicine, 8)Division of Cancer Information Service, Institute for Cancer Control, National Cancer Center, 9)School of Health Sciences, University of Occupational and Environmental Health, 10) Department of Advanced Preventive Medicine and Health Literacy, Graduate School of Medicine, Juntendo University
Health literacy can be defined as the ability of patients and other people to locate accurate health information, understand and utilize it, and finally to incorporate it into appropriate health behavior. It has been established that individuals with high health literacy tend to adopt appropriate health behavior; accordingly, they are less vulnerable to disease, and disease is less serious even if they do suffer from one. Recently, health literacy has attracted considerable worldwide attention among health researchers, including those in Japan. There has been an international increase in the number of papers dealing with this subject; dedicated international academic societies and a dedicated journal, Health Literacy Research and Practice, have been established overseas. Consequently, the present authors established the Japanese Health Literacy Association (JHLA) in 2019 and launched its official journal (Health Literacy) in 2022. Health literacy and health communication are closely related; thus, JHLA has come to merge its headquarters with those of the Japanese Association of Health Communication (JAHC), and JHLA holds its academic meetings together with JAHC in the framework of Health Communication Week. We expect further developments in research related to health literacy in Japan as a result of the founding of JHLA.
Takahiro Kiuchi
President of Japanese Health Literacy Association
Congress Chair of the First Annual Meeting of Health Literacy Association, Japan
Department of Health Communication, School of Public Health, The University of Tokyo
Nakayama, Kazuhiro
Graduate School of Nursing, St. Luke’s International University
Health literacy refers to the ability to access, understand, evaluate, and apply health and medical information to make appropriate decisions. It seeks to empower people so they may attain their innate potential. Health literacy can also serve as a powerful health promotion tool; it can be an agent of change in societies where citizens lack health information, face difficulties in making health decisions (even if they have the necessary information), or lack the appropriate environment or conditions to change their behavior.Amid a global push to measure health literacy, there have been calls to treat it as a human right owing to the difficulties faced by many individuals related to health information and the resultant health disparities. In Japan, a nationwide survey was conducted using a scale developed in the European Union; the survey found that a high proportion of the respondents faced health literacy difficulties. Specifically, the survey identified large differences in terms of evaluation and utilization of health knowledge; even if respondents were able to understand health information, they still had difficulty in making judgments and decisions based on it. The reasons were as follows: lack of opportunity for learning to evaluate the reliability of health information and inability to make decisions by checking the sufficiency of options; determining the advantages and disadvantages of each option; and clarifying the values that determine which of these options is important.Based on the premise of low health literacy, it is hoped that shared decision making (which is often discussed separately) will become more widespread; in that way, all individuals will be able to access reliable information and obtain support to make decisions that match their values. Therefore, it is necessary to identify the specific health literacy skills involved in the decision-making process and then develop and disseminate decision aids, i.e., tools that present the benefits and risks of all options in an easy-to-understand manner, to allow people to make healthcare choices with confidence.
Hirono Ishikawa
Teikyo University Graduate school of Public Health
Along with the evolving definition of health literacy, there have been various discussions about measuring such literacy, including measurement methods, content, and domains; many assessment tools have been developed. A simple scale comprising few items has been developed to screen patients with inadequate health literacy in clinical settings; however, more comprehensive, multi-item scales have also been formulated to assess the whole concept of health literacy based on its theoretical framework. In terms of measurement approaches, some tools are based on objective assessment of the skills in performing a task; there is also subjective assessment of the difficulty or confidence in performing a task. Health literacy is deeply embedded in an individual’s context and environment. The required skills and level of health literacy (i.e., evaluated content) vary according to age, health problems, health-care system, and social environment. Thus, health literacy has to be measured by considering the context of the study subjects, and it needs to be based on a universally accepted definition and framework. Such measurements should contribute to interventions toward improving health literacy problems.
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