Exploring critical health literacy in health education: A social justice approach

Objective: To explore the perspectives and practices of high school health education teachers implementing health literacy with a focus on the social determinants of health within the context of a concern for social justice. Design: Qualitative content analysis was used to assess high school teachers’ accounts of the practices used to teach health education in line with their professional preparation, the Texas Essential Knowledge and Skills (TEKS) standards, the textbook(s) used and the district’s health education curriculum. Setting: A large urban independent school district in southern Texas, USA. Method: Six high school health education teachers’ interviews were analysed using the social ecological framework and a social justice framework to identify themes that aligned with the teaching practices used to facilitate critical health literacy. Results: Although teachers were unfamiliar with the term Social Determinants of Health, they were able to speak to the challenges that their students faced in everyday life. The need for support and the remedying of knowledge deficits were two important themes. Conclusion: Health education teachers often lack the preparation to teach about the social determinants of health in a manner that resonates with students’ backgrounds. The current TEKS standards provide insufficient guidance, emphasising kinesiology, diet and movement over a focus on critical health literacy and the social determinants of health, resulting in a limited and inadequate curriculum for high school students.