Discourses in Interaction: The intersection of literacy and health research internationally

Julie Green
Joseph Lo Bianco
Johanna Wyn


Literacy and health are deeply influential in social participation, utilisation of social resources and quality of life. This paper discusses interacting discourses and common conceptual points shared by the adult literacy and public health fields and situates how the sub-field at the intersection of these two domains, known as ‘health literacy’, is constructed and enacted. Emerging approaches that recognise the convergence of education and health within international policy, research and in practice are articulated. The paper argues a case for re-thinking the literacy-health connection from a cross-sectoral perspective and for more effective approaches furthering the interests of both life-long learning and wellbeing. 

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Australian Bureau of Statistics (ABS) (1996) Aspects of Literacy, Australia Cat no. 4228.0, Australian Bureau of Statistics, Canberra.

Australian Institute of Health and Welfare (AIHW) (2004) Health Inequalities in Australia: Mortality, September 2004, Health Inequalities Monitoring Series no 1, Catalogue Number PHE 55 QUT and AIHW, Canberra.

Baker DW, Parker RM, Williams MV, Pitkin, K, Parikh, NS, Coates, W and Imara, M (1996) The Health Care Experience of Patients with Low Literacy, Archives of Family Medicine, vol 5, pp 329-34. http://dx.doi.org/10.1001/archfami.5.6.329

Baker, DW, Parker, RM, Williams, MV and Clark, WS (1998) Health Literacy and the Risk of Hospital Admission, Journal General Internal Medicine, December, vol 13, no 12, pp 791-8.

Barton, David and Hamilton, Mary (1998) Local Literacies: Reading and writing in one community, Routledge, London.

Barton, David, Hamilton, Mary and Ivanic, Ros (2000) Situated Literacies: reading and writing in context, Routledge, London.

Baynham, Michael (1995) Literacy Practices: Investigating literacy in social contexts, Routledge, London.

Baynham, Michael (2003), Adult Literacy, in Bourne, J and Reid, E, eds, Language Education, World Yearbook, 2003 Kogan Page, London, pp 109-126.

Beck, U and Beck-Gernsheim, E (2002) Individualization, Sage, Thousand Oaks, California.

Botsman, Peter and Latham, Mark (2001) The Enabling State, Pluto Press, Annandale, New South Wales.

Centre for Literacy (CLQ) (2000) A Working Definition: Literacy for the 21st century, retrieved on 13 December 2006 from www.centreforliteracy.qc.ca/def.htm, The Centre for Literacy of Quebec, Montreal, Canada.

Collins, J (1999) The Ebonics Controversy in Context, in Blommaert, J, ed, Language Ideological Debates, The Hague, Mouton, pp 201-235. http://dx.doi.org/10.1515/9783110808049.201

Cope, Brian and Kalantzis, Mary (2000) Multiliteracies, Routledge, London.

Cuban, S (2006) Following the Physician's Recommendations Faithfully and Accurately, Journal for Critical Education Policy Studies, vol 4, no 2, November, retrieved on 1 August 2007 from www.jceps.com/?pageID=article & articleID=74.

Davis, T, Crouch, M, Wills, G, Miller, S, and Abdehou, D (1990) Gap Between Patient Reading Comprehension and the Readability of Patient Education Materials, Journal of Family Practice, vol 31, no 5, pp 533-538.

Davis, T, Crouch, M, Wills, G, and Miller, S (1991) Rapid Assessment of Literacy Levels of Adult Primary Care Patients, Family Medicine, vol 23, no 6, pp 433-435.

Department for Education and Skills (2006) Skilled for Health: Making the case, London (unpublished).

Department of Health (2004) Choosing Health: Making healthy choices easier, Public Health White Paper, England, November.

Department of Human Services, (2006) Health Literacy and Effective Health Promotion for Vulnerable Communities, retrieved on 21st November 2006 from http://health.vic.gov.au/researchprograms/ Vic, Australia.

Dreger V and Tremback T (2002) Optimize Patient Health by Treating Literacy and Language Barriers, Association of Perioperative Registered Nurses, February, vol 75, no 2, pp 278-304.

Freebody, Peter and Freiberg, Jill (1997) Adult Literacy and Health, Language Australia, Melbourne.

Friedsam, D and Kindig, D (2004) Consumer Health Literacy, Wisconsin Public Health and Health Policy Institute Issue Brief, vol 5, no 4, May, http://pophealth.wisc.edu/uwphi/publications/birefs/may04brief.pdf.

Friere, P (1985) The Politics of Education, MacMillan, London.

Gazmararian, JA, Baker, DW, Williams, MV, Parker, RM, Scott, TL, Green, DC, Fehrenback, SN, Ren, J, Koplan, JP (1999) Health Literacy among Medicare Enrolees in a Managed Care Organisation, Journal of American Medical Association, February, vol 10, no 281, pp 545-51.

Hagston, Jan (2002) Exploring the International Adult Literacy Survey Data, Language Australia, Melbourne.

Hamilton, Mary (2001) Privileged Literacies, Language and Education, vol 15, nos 2 and 3, pp 178-196.

Hartley, Robyn and Horne, Jackie (2005) Social and Economic Benefits of Improved Adult Literacy, National Centre for Vocational Education Research, Adelaide, http://ncver.edu.au.

Heath, Shirley (1983), Ways With Words, Cambridge University Press, London.

Hohn Marcia, D (1998) Empowerment Health Education in Adult Literacy, National Institute for Literacy Washington, DC, retrieved on 5 August 2006 from www.nifl.gov/HOHN.htm.

Hohn Marcia, D (2004) A Peer Leadership and Empowerment Approach to Health Literacy Education, Literacy Harvest, Fall 2004, vol 2, no 1, Health Literacy, pp 12-18.

Houtts, PS, Bachrach, R, Witmer, JT, Tringali, CA, Bucher, JA, Localio, RA (1998) Using Pictographs to Enhance Recall of Spoken Medical Instructions, Patient Education and Counseling, vol 35, pp 83-88. http://dx.doi.org/10.1016/S0738-3991(98)00065-2

Houtts, PS, Witmer, JT, Egeth, HE, Loscalzo, MJ and Zabora, JR (2001) Using Pictorgraphs to Enhance Recall of Spoken Medical Instructions II, Patient Education and Counseling, vol 43, pp 231-242. http://dx.doi.org/10.1016/S0738-3991(00)00171-3

Institute of Medicine (IOM) (2004) Health Literacy, in Nielsen-Bohlman, L, Panzer, AM, Kindig, DA, eds, Institute of Medicine of the National Academies.

Kalman, J (1999) Writing on the Plaza, Hampton Press, Cresskill NJ.

Kelly, P (2006) The Entrepreneurial Self and 'Youth at-risk', Journal of Youth Studies, vol 9, no 1, pp 17-32. http://dx.doi.org/10.1080/13676260500523606

Kickbusch, I (2001) Health Literacy, Health Promotion International, vol 16, no 3, pp 289-297. http://dx.doi.org/10.1093/heapro/16.3.289

Kickbusch, Illona, Wait, Suzanne and Maag, Daniela, (2006) Navigating Health, International Longevity Centre, London, England.

Lindau, ST, Tomori, C, Lyons, T, Langseth L, Bennett, CL, Garcia, P (2002) The Association of Health Literacy with Cervical Cancer, American Journal of Obstetrics and Gynecology, vol 186, no 5, pp 938-43. http://dx.doi.org/10.1067/mob.2002.122091

Lo Bianco, Joseph and Freebody, Peter (2001) Australian Literacies, Language Australia, Melbourne.

Lonsdale, M and McCurry, D (2004) Literacy in the New Millennium, National Centre for Vocational Education Research, Publication 1490, www.ncver.edu.au/publications/1490.html.

Marmot, Michael (2004) Interview with Professor Michael Marmot, World Health Organisation, retrieved on 13 December 2006 from www.who.int/social_determinants/advocacy/interview_marmot/en/

Mizen, P (2004) The Changing State of Youth, Palgrave, New York.

National Centre for the Study of Adult Learning and Literacy (NCSALL) (2005) Learning How to Teach Health Literacy, vol 8, issue 3, retrieved on 13 December 2006 from ww.ncsall.net/?id=995.

National Institute for Literacy (1994) Literacy for Health, February 7, ERIC Document Reproduction Service, Springfield VA. ED404436.

National Institute of Health (2000) Current Bibliographies in Medicine, January 1990-October 1999, US Department of Health and Human Services, Bethesda, Maryland, No 2000-1.

Nussbaum, M and Sen, A (1993) The Quality of Life, Clarendon Press, Oxford. http://dx.doi.org/10.1093/0198287976.001.0001

Nutbeam, Don (1999) Literacies Across the Lifespan, Literacy and Numeracy Studies: An international journal in the education and training of adults, vol 9, no 2, pp 47-55.

Nutbeam, Don (2000) Health Literacy as a Public Health Goal, Health Promotion International, vol 15, no 3, September, pp 259-267.

Nutbeam, Don (2005) What Would the Ottawa Charter Look Like if It Were Written today?, International Union for Health Promotion and Education (IUHPE), retrieved on 20th November from www.rj[eo.org/reviews/2005/19/index.htm.

Nutbeam, D and Harris, E (1998) Theory in a Nutshell, Department of Public Health and Community Medicine, University of Sydney, NSW.

Nutbeam, Don and Kickbusch, Ilona (2000) Advancing Health Literacy, Health Promotion International, September 1, vol 15, no 3, pp 183-4.

Organisation for Economic Cooperation and Development, OECD (1996) Lifelong Learning for All, Organisation for Economic Cooperation and Development (OECD), Paris.

Organisation for Economic Cooperation and Development, OECD (1997) Literacy Skill for the Knowledge Society, Organisation for Economic Cooperation and Development (OECD), Paris.

Pamuk, E, Makuc, D, Heck, K, Reuben, C, and Lochner, K (1998) Socioeconomic Status and Health Chartbook, US, 1998, National Center for Health Statistics, Hyattsville, MD.

Parker, R, Baker, D, Williams, M, and Nurss, J (1995) The Test of Functional Health Literacy in Adults, Journal of General Internal Medicine, vol 10, pp 537-41. http://dx.doi.org/10.1007/BF02640361

Parsons, S and Bynner, J (1998) Influences on Adult Basic Skills, Basic Skills Agency, London.

Perrin, B (1989) Literacy and Health: Making the connection, Health Promotion, vol 28, no 1, pp 2-5.

Prinsloo, M and Breier, M (1996) The Social Uses of Literacy, Benjamins, Amsterdam. http://dx.doi.org/10.1075/swll.4

Ratzan SC and Parker RM (2000) Introduction, in Selden, CR, Zorn, M, Ratzan, SC, Parker, RM, eds, in National Library of Medicine Current Bibliographies in Medicine: Health Literacy, vol NLM Publication no CBM 2000-1, National Institutes of Health, US Department of Health and Human Services, Bethesda.

Riddell, S and Tett, L, eds (2001) Education, Social Justice and Inter-agency working, Routledge/Farmer, London.

Rootman, I and Ronson, B, (2005) Literacy and Health Research in Canada, Canadian Journal of Public Health, S63, March-April, pp 62-77.

Rudd, RE and Comings, JP (1994) Learner Developed Materials, Health Education Quarterly, Fall, vol 21, no 3, pp 313-327.

Rudd, Rima, Moeykens, Barbara and Colton, Taylor (1999) Health and Literacy, in Comings, J, Garners, B, Smith, C, eds, Annual Review of Adult Learning and Literacy, Josey-Bass, San Francisco.

Rudd, Rima, Kirsch, Irwin and Yamamoto K, (2004) Literacy and Health in America, ETS, retrieved on 10 November 2006 from www.ets.org/research/pic

Schillinger, D, Grumbach, K, Piett, J, Wang, F, Osmond, D, Daher C, Palacios, J, Sullivan, GD, Bindman, AB (2002) Association of Health Literacy with Diabetes Outcomes, Journal of American Medical Association, vol 288, pp 475-482. http://dx.doi.org/10.1001/jama.288.4.475

Schwab, RG and Sutherland, D (2004) Literacy for Life, Centre for Aboriginal Economic Policy Research (CAEPR), Australian National University, Australia, retrieved on 13 December 2006 from www.anu.edu.au/caepr/Publications/topical/LiteracyforLife.pdf

Shohet, Linda (2002) Health and Literacy: Perspectives, retrieved on 6 June 2006 from www.staff.vu.edu.au/alnarc/onlineforum/AL_pap_shohet.htm

Silverstein, M, Iverson, L and Lozano, P (2002) An English-Language Clinic-based Literacy Program is Effective for a Multilingual Population, Pediatrics, vol 109, no 5, e76. http://dx.doi.org/10.1542/peds.109.5.e76

Snyder, I, Jones, A and Lo Bianco, J (2005) Using Information and Communication Technologies in Adult Literacy Education, National Centre for Vocational Education Research (NCVER), ncver.edu.au

Street, Brian (1995) Social Literacies, Longman, London.

Street, Brian, ed, (2001) Literacy and Development, Routledge, London. http://dx.doi.org/10.4324/9780203468418

Street, Brian (2003) What's 'New' in New Literacy Studies?, Current Issues in Comparative Education, vol 5 no 2, pp 1-19.

Tassi, A (2004) The Emergence of Health Literacy as a Public Policy Priority, Literacy Harvest, Health Literacy, Fall, vol 2, no 1, pp 5-10.

Turrell, G, Stanley, L, de Looper M, and Oldenburg, B, (2006) Health Inequalities Monitoring Series No 2, AIHW April, AIHW Cat. No. PHE 72.

United Nations Eductional, Scientific and Cultural Organisation (UNESCO) (2005) Education For All Global Monitoring Report, http://portal.unesco.org/education/en/ev.php-URL_ID=35255 & URL_DO=DO_TOPIC & URL_SECTION=201.html

US Department of Health and Human Services (2001) Healthy People 2010, http://www.health.gov/healthypeople.

Victorian Government (2006) Creating A Fairer Victoria, retrieved on 9 December 2006 from www.vic.gov.au

Victorian Health Promotion Foundation (VHPF) (2005) Plan for Action 2005-2007, Victorian Health Promotion Foundation, retrieved on 12 March 2006 from www.vichealth.vic.health.gov.au

Weiss, Barry (2003) Health Literacy, American Medical Association.

Weiss, B, Hart, G, and Pust, R (1991) The Relationship Between Literacy and Health, Journal of Health Care for the Poor and Underserved, vol 1, no 4, pp 351-363. http://dx.doi.org/10.1353/hpu.2010.0294

Wickert, Rosie (2001) Politics, Activism Policy Production: Adult literacy in Australia, in Lo Bianco, J and Wickert, R, eds, Australian Policy Activism, Language Australia, Melbourne, pp 75-93.

Wierenga, A, Wyn, J, Glover, S and Meade, M (2003) Application of Enabling State Principles in the Delivery of Youth Services, Youth Research Centre, Melbourne.

Williams, M, Parker, R, Baker, D, Parikh, K, Coates, W and Nurss, J (1995) Inadequate Functional Health Literacy Among Patients at Two Public Health Hospitals, Journal of the American Medical Association, vol 2714, no 21, pp 1677-1682.

Williams MV, Baker DW, Honig EG, Lee, ML and Nowlan, A (1998) Inadequate Literacy is a Barrier to Asthma Knowledge and Self-care. Chest, vol 114, pp 1008-15. http://dx.doi.org/10.1378/chest.114.4.1008

World Health Organisation (WHO) (1986), 21 November, retrieved on 4 October 2006 from www.who.int/hpr/NPH/docs/ottawa_charter_hp.pdf

World Health Organisation (WHO) (1998) World Health Declaration, May, www.who.int

DOI: http://dx.doi.org/10.5130/lns.v15i2.2205