The concept of health literacy

This chapter starts by reviewing narrow and broad definitions of the concept of health literacy and summarizing its various components in a skill attainment model. The model adds to functional health literacy (reading and numeric skills) layers of declarative knowledge (explicit knowledge that can be verbalized), procedural knowledge (knowledge of how to do things), and judgment skills. The use and application of judgment skills is understood as an issue of patient empowerment, but health literacy is not meant to replace the physician's professional knowledge, skills, and competence. In a second step, ways to measure health literacy are reviewed, including both standard measures of functional health literacy and measures under different labels that may be employed to assess other components of the concept. In a third step, procedural knowledge and judgment skills are looked at from a different angle and identified as an example of Aristotle's classic concept of practical wisdom. Finally, a case study is added to illustrate the importance of including basic health information in school curricula together with emphasizing the knowledge-based fundamentals of health literacy. It addresses the progressive resistance to antibiotics due to their improper use and finds that basic reading and writing skills are not sufficient to face important challenges in the field of health nowadays, that it cannot be taken for granted that important health issues are covered by media or in medical consultation, and that a judicious use of antibiotics appears to go along not just with the indispensable amount of declarative knowledge but with judgment skills.