Encyclopedia
Please note this is a comparison between Version 2 by Amina Yu and Version 1 by Anabel Ramos-Pla.
There has been an emphasis on the importance of health literacy (HL) and health education (HE) as basic tools to empower individuals and the community. The increasing interest in HL and HE has been observed through the evolution of publications and the nature of the main trends in the last few years. Knowing how HL and HE have evolved in scientific publications can help us to identify trends and set work priorities in this scope.
- health literacy
- health education
- bibliometric analysis
- VOSviewer
- RStudio
- machine learning
1. Introduction
The origins of the concept of Health Literacy (HL) go back to 1974, when S.K. Simonds associated it with another closely-related concept, Health Education (HE) [1]. Both concepts were defined in the area of school education, and it was not until 1998 that the World Health Organization (WHO) adopted HL as a concept also in the area of public health, defining it as “cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health” [2]. Posteriorly, the WHO further developed this concept, introducing nuances which defined the objective of HL as “to take action to improve personal and community health by changing personal lifestyles and living conditions” [3]. Starting with this definition, the WHO highlighted that HL is fundamental for the personal, social, and cultural development of individuals, and could therefore have an influence on the health of individuals, in a critical manner for health empowerment. At the same time, HE was defined as the “opportunities for learning involving some form of communication designed to improve HL, including improving knowledge, and developing life skills which are conducive to individual and community health” [4]. In this sense, HE promotes HL, given that it is the education process of the population in general, and that of each individual, which promotes changes towards healthy behaviors [5,6]. Therefore, both concepts are encompassed within the concept of health promotion, with it being a necessity, and at the same time a priority, especially in health and school systems, as a pillar in the maintenance and improvement of health conditions [7,8].
Likewise, delving further into the framework of the European Health Literacy Project, HL also contemplates the competences of individuals in understanding, evaluating and applying health information to maintain and improve the quality of life [9].
The increasing interest in HL and HE has been observed through the evolution of publications and the nature of the main trends in the last few years. Knowing how HL and HE have evolved in scientific publications can help us to identify trends and set work priorities in this scope.
2. Health Literacy and Its Construction as a Concept
There are three levels in HL: (i) functional: basic competences of reading and writing to act efficiently in a health context; (ii) interactive: cognitive and social skills that allow for active participation in subjects related to health; and (iii) critical: competences associated with the making of decisions starting with a critical analysis and the use of information to participate in health actions [10,11, 22]. These three levels articulate the degree of knowledge acquired by each individual as a function of age, culture, and prior knowledge, among others.
Aside from these three levels, there are three dimensions based on a conceptual model with respect to HL, and which must be considered to ensure the correct literacy in this area: attention and care; prevention of diseases, and health promotion. Starting with these three dimensions, we find four more, which refer to the processing of information, based on the logical model: accessing, understanding, processing, and application of the information received about health subjects [5,6,9,12,13,14]. The Sørensen model combines these two models and creates a new integrated model in which other factors are considered, such as determinants (social and environmental, situational, and personal), or the course of life, so that social, anthropological, and psychological approaches can be established around the concept and application of HL [14].
3. Health Literacy and Its Relevance Today
The interest of the general population and the need to implement real HL in education contexts has increased, given its high impact on health results, in which a greater HL is associated with a better state of health. In this sense, many studies [15,16,17] have stated that a greater HL, along with a greater empowerment, improves the competence of decision-making, and therefore, the individual acquires a more active role in the process. Diverse authors have pointed out that the different health literacy programs or projects, which were mainly conducted in Compulsory Secondary Education, improved the results regarding health knowledge and emotional well-being, and empowered students to seek help when they needed it [18,19,20].
The health crisis due to COVID-19 has further highlighted, if possible, the need for HL through the implementation of HE, given that the general population has had to rapidly learn and apply a set of health measures and protocols to contain the expansion of SARS-CoV-2 [21,22,23].
The evolution of HL and HE concepts has become consolidated in the last few decades. Thus, the objective of this review is to conduct a quantitative bibliometric analysis to discover what the advances and changes have been with respect to HL and HE in the last few years. The results obtained will allow us to identify the trends and priorities in this field, as this method is efficient and effective for quantitatively describing the influence of a subject through time [24,25,26,27].
The number of publications over the last ten years indicates an expanding interest on this topic. Furthermore, the large number of terms closely related with HL and HE, identified in this study in five different clusters, shows the extensive scope that these two concepts have in health. The focus on what issues are relevant, in terms of HL and HE have evolved through the years going form aspects more related to illness, care and adultness, to others more closely to adolescents and children, prevention of mental health issues and even COVID-19. It can be perceived that, due to the challenges experienced in recent years with the COVID-19 pandemic situation, in the coming years the research in HL and HE will be relevant in mental health literacy. How to act, from the area of HE on vulnerable populations such as adolescents, how to increase knowledge on mental health management, how to modify their beliefs and attitudes or how to reduce the stigma on mental health will be the new challenges to face.
HL and HE are very broad concepts covering many different keywords. Deeper bibliometric analyses are required, in which specific cluster of terms are considered, to learn more about differences in the evolution of scientific production on this field.
1. Introduction
The origins of the concept of Health Literacy (HL) go back to 1974, when S.K. Simonds associated it with another closely-related concept, Health Education (HE) [1]. Both concepts were defined in the area of school education, and it was not until 1998 that the World Health Organization (WHO) adopted HL as a concept also in the area of public health, defining it as “cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health” [2]. Posteriorly, the WHO further developed this concept, introducing nuances which defined the objective of HL as “to take action to improve personal and community health by changing personal lifestyles and living conditions” [3]. Starting with this definition, the WHO highlighted that HL is fundamental for the personal, social, and cultural development of individuals, and could therefore have an influence on the health of individuals, in a critical manner for health empowerment. At the same time, HE was defined as the “opportunities for learning involving some form of communication designed to improve HL, including improving knowledge, and developing life skills which are conducive to individual and community health” [4]. In this sense, HE promotes HL, given that it is the education process of the population in general, and that of each individual, which promotes changes towards healthy behaviors [5][6]. Therefore, both concepts are encompassed within the concept of health promotion, with it being a necessity, and at the same time a priority, especially in health and school systems, as a pillar in the maintenance and improvement of health conditions [7][8].
Likewise, delving further into the framework of the European Health Literacy Project, HL also contemplates the competences of individuals in understanding, evaluating and applying health information to maintain and improve the quality of life [9].
The increasing interest in HL and HE has been observed through the evolution of publications and the nature of the main trends in the last few years. Knowing how HL and HE have evolved in scientific publications can help to identify trends and set priorities in the scope.
2. Health Literacy and Its Construction as a Concept
There are three levels in HL: (i) functional: basic competences of reading and writing to act efficiently in a health context; (ii) interactive: cognitive and social skills that allow for active participation in subjects related to health; and (iii) critical: competences associated with the making of decisions starting with a critical analysis and the use of information to participate in health actions [10][11][12]. These three levels articulate the degree of knowledge acquired by each individual as a function of age, culture, and prior knowledge, among others.
Aside from these three levels, there are three dimensions based on a conceptual model with respect to HL, and which must be considered to ensure the correct literacy in this area: attention and care; prevention of diseases, and health promotion. Starting with these three dimensions, it was found four more, which refer to the processing of information, based on the logical model: accessing, understanding, processing, and application of the information received about health subjects [5][6][9][13][14][15]. The Sørensen model combines these two models and creates a new integrated model in which other factors are considered, such as determinants (social and environmental, situational, and personal), or the course of life, so that social, anthropological, and psychological approaches can be established around the concept and application of HL [15].
3. Health Literacy and Its Relevance Today
The interest of the general population and the need to implement real HL in education contexts has increased, given its high impact on health results, in which a greater HL is associated with a better state of health. In this sense, many studies [16][17][18] have stated that a greater HL, along with a greater empowerment, improves the competence of decision-making, and therefore, the individual acquires a more active role in the process. Diverse authors have pointed out that the different health literacy programs or projects, which were mainly conducted in Compulsory Secondary Education, improved the results regarding health knowledge and emotional well-being, and empowered students to seek help when they needed it [19][20][21].
The health crisis due to COVID-19 has further highlighted, if possible, the need for HL through the implementation of HE, given that the general population has had to rapidly learn and apply a set of health measures and protocols to contain the expansion of SARS-CoV-2 [22][23][24].
The evolution of HL and HE concepts has become consolidated in the last few decades. Thus, it is to conduct a quantitative bibliometric one to discover what the advances and changes have been with respect to HL and HE in the last few years. The results obtained will be allowed to identify the trends and priorities in this field, as this method is efficient and effective for quantitatively describing the influence of a subject through time [25][26][27][28].
The number of publications over the last ten years indicates an expanding interest on this topic. Furthermore, the large number of terms closely related with HL and HE, identified in five different clusters, shows the extensive scope that these two concepts have in health. The focus on what issues are relevant, in terms of HL and HE have evolved through the years going form aspects more related to illness, care and adultness, to others more closely to adolescents and children, prevention of mental health issues and even COVID-19. It can be perceived that, due to the challenges experienced in recent years with the COVID-19 pandemic situation, in the coming years, HL and HE will be relevant in mental health. How to act, from the area of HE on vulnerable populations such as adolescents, how to increase knowledge on mental health management, how to modify their beliefs and attitudes or how to reduce the stigma on mental health will be the new challenges to face.
HL and HE are very broad concepts covering many different keywords. Deeper bibliometric analyses are required, in which specific cluster of terms are considered, to learn more about differences in the evolution of scientific production on this field.
