Health literacy in chronic disease management: a matter of interaction.

Health literacy plays a crucial role in chronic disease management. To comprehensively manage chronic conditions on a daily basis, individuals must be able to assess, understand, evaluate, and use health information. Several key publications emphasize that health literacy is not merely a matter of individual skills but that it is highly dependent on the accessibility of health-care systems, the communication skills of health-care professionals, and the level of complexity of the health information. However, the literature indicates that health literacy is mainly framed and measured as an individual attribute in research. Focusing health literacy research solely on the individual, rather than also including the health-care context, limits our understanding of the type of actions that should be undertaken to facilitate a person's access to and understanding, evaluation and use of health information. This commentary highlights the importance of interpreting the concept of health literacy as a dynamic construct that emerges from the interaction between patients/citizens and health-care systems, organizations, and professionals. This approach has the potential to fill a gap in our understanding of the link between health literacy and chronic disease management. Such an understanding would facilitate the development of comprehensive health literacy measurement instruments and interventions to enhance health literacy.

Alcohol's role in the deaths of BC children and youth.

OBJECTIVE: To determine the prevalence and context of alcohol use in the deaths of children and youth reviewed by the BC Children's Commission. METHODS: In 489 case reviews of BC children and youth, we examined the role that alcohol may have had at the time of death or whether there was a history of alcohol use either by the deceased child or another person in the child's life. RESULTS: Alcohol is most prevalent in the lives of 15-18 year olds. It is present at the time of death in two fifths of Motor Vehicle Incidents (MVI) and one third of suicides and drownings. INTERPRETATION: Alcohol has a profound presence in the lives and deaths of children reviewed by the Children's Commission. Enhancing deterrence laws and alcohol control policies, and increasing public awareness are warranted.