Health literacy, health inequality and a just healthcare system
American Journal of Bioethics 7 (11):5 – 10 (2007)
| Abstract | Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy. | |||||||||
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Jozsef Kovács (1989). Concepts of Health and Disease. Journal of Medicine and Philosophy 14 (3):261-267.
Jeffrey D. Milyo & Jennifer M. Mellor (1999). Is Inequality Bad for Our Health? Critical Review 13 (3-4):359-372.
Vail M. Miller (2007). Poor Ehealth Literacy and Consumer-Directed Health Plans: A Recipe for Market Failure. American Journal of Bioethics 7 (11):20 – 22.
Lennart Nordenfelt (1998). On Medicine and Health Enhancement - Towards a Conceptual Framework. Medicine, Healthcare and Philosophy 1 (1):5-12.
Norman Daniels (2008). Just Health: Meeting Health Needs Fairly. Cambridge University Press.
Wilson James (2009). Not So Special After All? Daniels and the Social Determinants of Health. Journal of Medical Ethics 35:3 - 6..
Dan W. Brock (2000). Broadening the Bioethics Agenda. Kennedy Institute of Ethics Journal 10 (1).
Norman Daniels (2001). Justice, Health, and Healthcare. American Journal of Bioethics 1 (2):2 – 16.
Angelo Volandes & Michael Paasche-Orlow (2007). Response to Open Peer Commentaries on "Health Literacy, Health Inequality and a Just Health Care System". American Journal of Bioethics 7 (11):1-2.
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