Transforming children's health spaces into learning places

Health literacy as a discrete form of literacy is becoming increasingly important for social, economic and health development. The positive and multiplier effects of education and general literacy on population health, particularly women's health, are well known and researched. However, a closer analysis of the current HIV/AIDS epidemics, especially in Africa, indicates a complex interface between general literacy and health literacy. While general literacy is an important determinant of health, it is not sufficient to address the major health challenges facing developing and developed societies. As a contribution to the health literacy forum in Health Promotion International, this paper reviews concepts and definitions of literacy and health literacy, and raises conceptual, measurement and strategic challenges. It proposes to develop a set of indicators to quantify health literacy using the experience gained in national literacy surveys around the world. A health literacy index could become an important composite measure of the outcome of health promotion and prevention activities, could document the health competence and capabilities of the population of a given country, community or group and relate it to a set of health, social and economic outcomes.

This study examined the extent to which continuities and discontinuities in cognitive performance between ages 5 and 10 predicted adult income, educational success, household worklessness, criminality, teen parenthood, smoking, and depression. Assessed were the degree of this change during middle childhood, the influence of socioeconomic status (SES) on this change, and the extent to which this change influenced adult outcomes. The analyses were conducted on 11,200 individuals from the UK Birth Cohort Study who were born in 1970 and who were resurveyed at ages 5, 10, 16, 26, and 30. Substantial discontinuities emerged during middle childhood, with strong SES influences. Changes in middle childhood strongly affected adult outcomes, often outweighing the effects of cognitive development before age 5.