Health literacy and the social determinants of health: a qualitative model from adult learners

Gillian Rowlands, Adrienne Shaw, Sabrena Jaswal, Sian Smith, Trudy Harpham

Research output: Contribution to journalArticlepeer-review

75 Citations (SciVal)


Health literacy, ‘the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health’, is key to improving peoples’ control over modifiable social determinants of health (SDH). This study listened to adult learners to understand their perspectives on gathering, understanding and using information for health. This qualitative project recruited participants from community skills courses to identify relevant ‘health information’ factors. Subsequently different learners put these together to develop a model of their ‘Journey to health’. Twenty-seven participants were recruited; twenty from community health literacy courses and seven from an adult basic literacy and numeracy course. Participants described health as a ‘journey’ starting from an individual's family, ethnicity and culture. Basic (functional) health literacy skills were needed to gather and understand information. More complex interactive health literacy skills were needed to evaluate the importance and relevance of information in context, and make health decisions. Critical health literacy skills could be used to adapt negative external factors that might inhibit health-promotion. Our model is an iterative linear one moving from ethnicity, community and culture, through lifestyle, to health, with learning revisited in the context of different sources of support. It builds on existing models by highlighting the importance of SDH in the translation of new health knowledge into healthy behaviours, and the importance of health literacy in enabling people to overcome barriers to health.

Original languageEnglish
Pages (from-to)130-138
Number of pages9
JournalHealth Promotion International
Issue number1
Early online date28 Sept 2015
Publication statusPublished - 1 Feb 2017


  • Adult
  • Aged
  • Education
  • England
  • Ethnic Groups
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice
  • Health Literacy
  • Humans
  • Male
  • Middle Aged
  • Qualitative Research
  • Socioeconomic Factors


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