Individual and communal dimensions of health literacy: Evidence from Japan

While heath literacy is considered important for both personal and community health, empirical research on health literacy has generally focused on only individuals' personal skills. Health literacy also has a communal dimension which allows individuals lacking the necessary skills to achieve their health goals with assistance from other members of their social networks. This exploratory study assessed Japanese people's health literacy on both individual and communal dimensions. It also examined the relationship between these two dimensions of health literacy and a number of other individual- and community-level factors. A survey was administered to 672 people (male: 303, female: 369, ages 30-59) from 6 communities (3 urban and 3 suburban) in Japan. Personal health literacy was measured by asking whether the respondents could access, understand, and critically evaluate health information when needed. Other-mediated health literacy was measured by asking whether the respondents could find somebody else to help them access, understand, and critically evaluate health information when needed. Both scales of health literacy exhibited good internal consistency (Cronbach's alpha: personal, 0.77; other-mediated, 0.91). Confirmatory factor analysis showed that the two dimensions should be kept separate rather than lumped together. In contrast to personal health literacy, other-mediated health literacy was strongly correlated with community factors, such as the recognition of the community activity (personal: NS, other-mediated: p<0.01), cohesion in neighborhood (personal: NS, other-mediated: p<0.001), and mental attachment to community (personal: NS, other-mediated: p<0.01). This suggests the potential for using social networks to overcome health literacy challenges.