Gesundheitskompetenz und Gesundheitszustände
The relevant contribution “Digilog” can make in promoting health literacy and general health
Over 40 million Germans, i.e. over half of the German population, find it difficult to keep themselves healthy (cf. Sørensen, 2015). In comparison to society as a whole, people in this group exhibit riskier behaviour in terms of health, are less healthy and are admitted to hospital more frequently. It is, for example, hard for them to understand the package information leaflet of their medication or the nutritional information displayed on food packaging. They find it difficult to access reliable information on medical conditions and to assess whether seeking a second medical opinion would be necessary and prudent (cf. Schaeffer et al., 2017).
Even though older people, socially disadvantaged and less-educated sections of society account for a larger share of this group (fig. 1, influencing factors), people of all ages, all social statuses and all educational levels are affected by adverse health behaviour, poor health status and acute or intensive use of the health care system (fig. 1, Health outcome) - in short: by inadequate health literacy competencies (cf. Kickbusch et a., 2016).
Figure 1: Factors influencing health literacy and health outcomes (adapted from Sorensen et al. (2012))
Health literacy refers to "people’s knowledge, motivation and competencies to access, understand, assess and apply relevant health information in various forms in order to make judgements and take decisions in everyday life concerning [health care], disease prevention and health promotion to maintain or improve their quality of life throughout their lives" (Kickbusch et al., 2016, p. 6). (Kickbusch et al., 2016, p. 6).
As the manifestations of health literacy influence the actions of the individual as well as society, i.e. affect people's behaviour in terms of health and their state of health, this raises the question of how to promote health literacy.
Regarding the status of health literacy in Germany, it can be argued that the education system is not yet sufficiently prepared for the requirements of fostering comprehensive and long-term health literacy, for example by teaching basic skills such as reading, listening, logical thinking and awareness to the importance of one's own health. At the same time, compensating for these missing skills, in terms of lifelong learning, does not seem to have been fully successful, in that acquired knowledge and skills would have improved the health of the population.
At the same time, it should be noted that the context in which health literacy is to be achieved is challenging. For example, it seems paradoxical that there is active promotion of relatively unhealthy foods and lifestyles as well as a highly complex health system, which makes it difficult to find and manage health-related information. (Schaeffer et al., 2018).
This makes it all the more important to consider health literacy as an issue for society as a whole and to proceed systematically with regard to its promotion (WHO, 1986, 2016), in order to be able to develop the wide-ranging sub-competencies (Fig. 2).
Figure 2: Sub-dimension 'Application of health-relevant information' from the HLS-EU conceptual model (Sorensen et al., 2012), extended by the transfer to E-health
Following this, the National Framework on Health Literacy (Schaeffer, et al., 2017 & 2018a, b) calls for the inclusion of health literacy in education and the curriculum by means of 15 points and associated solutions. Communication between the health professions and patients must also be made clearer, easier to understand and more effective, and patient participation must be facilitated and strengthened (cf. Schaeffer, 2018a, pp. 32-51).
If these requirements for the development of health literacy are coupled with the potential of e-health1 approaches, the focus should above all be on digital solutions, e.g. wearables, firstly to improve the vastly inadequate health literacy, but moreover to provide products and services that have the potential to offset the existing, low level of health literacy. For this purpose, an ECG sensor was developed in the 'digilog' joint project, which records heart beats wirelessly. The data can be transferred via Bluetooth to a smartphone and to a secure data storage device. In this respect, it is possible to contribute towards maintaining health both preventively and in acute situations. If successful, patients will be supported in making more informed decisions about e-health services, avoiding health risks and acting preventively by means of information provided to them by trained health professionals.
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