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首页> 美国卫生研究院文献>International Journal of Environmental Research and Public Health >Health Literacy: From a Property of Individuals to One of Communities
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Health Literacy: From a Property of Individuals to One of Communities

机译：健康素养：从个人财产到一个社区

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Health literacy (HL) is increasingly hailed as a strategy to improve the control individuals have over their health. A central critic of HL intervention is its overemphasis on individual level factors, something recognised in the 2008 report of the Commission of Social Determinants of Health (SDoH) that recommended expanding the scope of HL to cover the SDoH. The objective of our study was to assess the extent to which recent progress on HL captures the need for collective action on the SDoH. We conducted a scoping review on PubMed looking for review papers published between 2013–2018 in English and French. Definitions of HL were analysed against two main dimensions (i.e., locus of change of HL strategies and foreseen outcome of HL improvements). Despite a number of authors calling for more research on HL interventions at the community level and an expansion of the definition to cover the SDoH, we found that the recommendation of the Commission has yet to be implemented. Even when the definitions include the capacities of individuals on distal determinants, both the locus of change and outcomes of HL improvement do not go beyond intra individual factors (knowledge, skills, etc.). It is noteworthy that communities were either framed as a setting outside of health care services or as an aggregate of individuals. We found no instance of HL intervention regarding communities as complex systems of actors sharing a common space and dynamic. We conclude by suggesting a new definition of HL and by drawing attention to the research gap in addressing the upstream SDoH through HL actions.
机译：健康素养（HL）越来越被视为一种改善个人对健康的控制策略。对HL干预的主要批评者是过分强调个人水平因素，这一点在2008年健康问题社会决定因素委员会（SSH）报告中得到了认可，该建议建议将HL的范围扩大到涵盖SSH。我们研究的目的是评估在HL方面的最新进展在多大程度上反映了对SNH采取集体行动的需要。我们对PubMed进行了范围界定的审查，以寻找2013-2018年之间以英语和法语发表的审查论文。针对HL的定义从两个主要方面进行了分析（即HL策略的变化轨迹和可预见的HL改善结果）。尽管有许多作者呼吁在社区一级对HL干预进行更多的研究，并且将定义扩展到涵盖SSH，但我们发现委员会的建议尚未实施。即使定义包括个体对远端决定因素的能力，变化的轨迹和HL改善的结果也不会超出个体内部因素（知识，技能等）。值得注意的是，社区要么被设置为医疗服务之外的环境，要么被视为个人的集合。我们没有发现将社区视为共享共同空间和动态的复杂参与者系统的高级别干预实例。最后，我们提出了有关HL的新定义，并提请人们注意通过HL行动解决上游SH的研究空白。

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