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Communication Bill Brieger | 18 Jan 2011 07:18 am

Health literacy – misnomer at best, abusive at worst

Health literacy was a term coined to express people’s knowledge of useable health information.  Although the word ‘literacy’ is obviously about reading, just an numeracy is about one’s ability to comprehend and perform mathematical functions, it has been used because no one has come up with a comparable single word like ‘healtheracy’.

school-under-the-mangoes-sm.jpgThe implications of this concept introduces a prejudice into the coversation about health.  Especially in developing societies the word literate shines with positivity, while saying someone is illiterate is a term of abuse.  Are we therefore implying, even if we don’t say it, that people who lack our ideas of ‘health literacy’ are health illiterates?

Health knowledge is a culutral commodity.  Orthodox scientific knowledge about health is one cultural manifestation of what people know about what makes us healthy and what makes us unwell.  If not carefully used though, one can come across as saying that this scientific knowledge is the ‘correct’ way of viewing the world, and everyone else is ‘illiterate’ or wrong.  The term clearly can have neo-colonialist connotations.

Communities have local knowledge about the cause, effects, treatment and prevention of common ailments that have survival benefits and also some negative consequences. Scientific knowledge is also not without negative consequences since it is an evolving process – like knowledge in any cultural setting. What may seem scientifically correct today may be found to be misleading or dangerous tomorrow.  While we give science the benefit of the doubt when crafting our health literacy campaigns, we are not so charitable with local knowledge.

Neglecting local knowledge in the name of health literacy is a one way conversation.  Behavior change will never occur without dialogue where both parties learn from each other.  By engaging in a dialogue that shows respect for different point of view we can arrive at a solution that not only promotes health, but does so in ways that are culturally acceptable.

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