The Social-Ecological Context of Health Literacy

Due to its association with health, social, and educational indicators, health literacy has increasingly become the focus of scientific interest in recent decades. Its public health importance can be highlighted by the fact that limited health literacy is correlated with poorer medication adherence, reduced ability to interpret health messages and to effectively access and communicate with health care professionals, limited use of early diagnosis and screening, less participation in health promotion and prevention activities, higher probability of risky health behaviors, poorer overall health status, and higher mortality rates. In addition to the detrimental effects on health, health literacy is also linked to educational outcomes, making health literacy important in the context of health inequalities. Therefore, the promotion of health literacy can offer an important contribution to the overall health status of the population. However, the relation of the concept to other existing and well-researched concepts (e.g. models of health behavior, health promotion) is not much discussed, and there is also critical debate about the best way to improve health literacy in different target groups and settings.

Despite the importance of the topic, debate continues about the conceptual frameworks of health literacy, such as the relationship between individual, community, and organizational levels of health literacy. There remains a research focus on the concept at an individual level, but we know less about the organizational, community or policy levels within a social-ecological model of health, and how individual capacity can help to build these levels. The settings within which health literacy exists and can be developed, the effective strategies to improve health literacy, and the evaluation of such interventions are also under-researched.

The aim of the current Research Topic is to explore the concept of health literacy within a social-ecological framework of health and build understanding of how it can be developed beyond an individual level at organizational, community, and population levels. In doing so we are interested in how health literacy relates to established concepts and how it is embedded in different settings (e.g. schools, companies, health care, communities, and digital realms) and for different target groups (e.g. young people, adults, vulnerable groups). It is also of utmost importance to discuss the strategies for improvement, including digital health literacy, which has become a priority.

Areas to be covered in this Research Topic may include, but are not limited to:
● Health literacy at the level of social and community networks;
● Health literacy in living and working environments (e.g. educational settings, occupational settings, health care settings);
● Health literacy in digital and virtual settings (digital and eHealth literacy);
● Health literacy at the macro level (policies, regulations);
● Methodological aspects to measure and assess health literacy beyond the individual level;
● Theoretical aspects of health literacy in relation to social-ecological concepts of health (e.g. health promotion, health education);
● Health literacy interventions and best practices in different settings and levels of the social-ecological approach.

We welcome a broad range of papers: Clinical Trial; General Commentary; Hypothesis and Theory; Methods; Mini Review; Opinion; Original Research; Perspective; Policy and Practice Reviews; Review; Systematic Review; Brief Research Report; Policy Brief; Community Case Study; and Curriculum, Instruction, and Pedagogy.

We would like to acknowledge Dr. Orkan Okan, who acted as coordinator and contributed to the preparation of the proposal for this Research Topic.