Critical health literacy: reflection and action for health.

ABSTRACT

Health literacy research is growing rapidly and broadly; however, conceptual advances in critical health literacy (CHL) seem hampered by a lack of a clear definition. In this paper, we refer to key features of the concept as identified in earlier works, offer a new definition of CHL and briefly discuss its theoretical roots. Reflection and action are suggested as the two constituent components of CHL. Consequences for future research are also discussed.

Critical health literacy (CHL) has been a term circulating in health promotion discourse for over 20 years; however, its definition has been vague and without firm theoretical grounding. This has often led to confounding CHL with 'critical literacy'. To disentangle these terms, we offer a new definition of CHL as the ability to reflect upon health determining factors and processes and to apply the results of the reflection into individual or collective actions for health in any given context. Reflection is a critical attitude towards socio-cultural realities that shape lives. Action is the ability to change these realities. Reflection and action work together. In our theoretical argument, we acknowledge CHL's roots in critical emancipatory theory and review CHL's recent treatment as an approach that provides awareness of social and cultural conditions. Our definition refers to reflection and action and their significance in the reproduction of social inequalities. We suggest that our theoretical framework can provide a focus for CHL's application in research on health inequalities, the foundation for future CHL assessments, and a starting point for discussion about CHL's potential theoretical orientations in public health and health promotion.