Literacy and Health

This year's theme for International Literacy Day is "Literacy and Health". As in the case of literacy and income, there is a relationship, yes. The two are linked somehow. But it's unclear to me that strong literacy skills produce higher income or better health, rather than the other way around.

Nonetheless, education is a health determinant that, as literacy workers, we can support. In 2004, Cheryl Brown and I wrote of literacy work and the determinants of good health for the Literacies Journal:

"Thirty years ago, A new perspective on the health of Canadians: a working document (Lalonde), introduced Canadians to a new health paradigm. The approach was preventive rather than reactive. It defined health in positive terms, as an asset everyone possessed in some degree, rather than negatively as the absence of illness or disability. It looked at health holistically and related it to a constellation of different concepts and contexts. Moving beyond the paradigm of hospital and medical professionals, the report spoke of the individual’s responsibility for determining their own health, and of a family, community and societal responsibility we share for each other’s well-being.

"Not all of these ideas were well explored or understood in 1974. Initially, there was an emphasis on personal choice and individual actions, and a downplaying of collective action or the role of local, physical environments (McKay). This led to rather limited social marketing campaigns such as ParticipAction and the Canada Food Guide (Kirby). However, it also led to Health Canada’s broader Population Health Approach, a paradigm for health care that has won worldwide respect. The 2004 Population Health Approach lists twelve determinant factors that work alone or in concert to influence our state of health.

"The [health] determinant Education and Literacy is within the reach of any program or project that supports individual learning. Education “contributes to health and prosperity by equipping people with knowledge and skills for problem solving, and…improves people’s ability to access and understand information to help keep them healthy” (Health Canada). A literacy program can support participants’ acquisition of health-relevant skills and information simply by ensuring that the curriculum content is relevant to each learner’s interest in and perception of effective self-care and health care. A recent document by Heart Health Nova Scotia demonstrated success with this approach, embedding literacy within the context of learners and tutors researching and learning about health issues. In our practice, we provide basic information, from a variety of sources and in both print and audio format, on topics from the link between food and health to the importance of breastfeeding. We sometimes provide recipes for using alternatives to wheat or milk as part of a class project or in a more individualized, door-to-door manner. We have offered information on food additives and the benefits of organic fruit and produce, and, in some cases, provided learners with small amounts of buckwheat flour or unsalted organic butter so that they could experiment on their own before deciding whether or not to spend money on admittedly more expensive products. Meanwhile, we would continue to integrate health information directly into the curriculum, helping learners and families take more control over their own health by reading and writing about the health issues most important to them."

We were, however, wary of over-selling literacy as a health determinant. It is one of twelve, and not the easiest one to provide in a context of weak health:

"Improved literacy becomes a receding goal when a learner’s poor health acts as a barrier to learning. It is hard to learn when you are hungry or when ingredients in the food you have eaten interfere with your thinking. It is difficult to focus when you are in chronic pain or when you are taking medication. It is hard to maintain regular program attendance or to demonstrate a commitment to learning when you are making frequent trips to a doctor’s office or the emergency ward. It is almost impossible for an organization to show funders that their program is viable and effective when learners are out for a week or more at a time as illness moves through their families."

For a useful introduction and description of the Population Health Approach go to www.hc-sc.gc.ca/hppb/phdd/approach/index.html.

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