Sağlık Okuryazarlığını Yeniden Düşünmek: Birey, Kurum ve Sistem Boyutunda Eleştiriler

Health literacy, defined as individuals’ ability to access, understand, evaluate, and use health-related information, is considered a critical factor in improving health outcomes, enhancing the effectiveness of healthcare services, and strengthening patients’ control over their health. However, this study highlights that despite its growing prominence, health literacy faces theoretical, methodological, and practical challenges at individual, institutional, and systemic levels. From a theoretical perspective, persistent conceptual ambiguities and difficulties in establishing universal definitions hinder standardization and comparability in both research and policy-making. The diversity of cultural, socioeconomic, and linguistic contexts further complicates the development of a single, universally applicable model. This reveals an urgent need for flexible, interdisciplinary, and context-sensitive approaches. Furthermore, the prevalent emphasis on individual responsibility in health literacy discussions has been criticized for overlooking the critical roles of health systems and social determinants. This individual-centric framing risks neglecting structural and organizational shortcomings, thereby perpetuating health inequalities. Instead, a balanced perspective that acknowledges institutional and policy-level responsibilities is essential. The concept of “corporate health literacy” underscores the importance of healthcare organizations in providing accessible, understandable, and culturally sensitive information, thus reducing the undue burden placed on individuals. Measurement and evaluation pose additional challenges. Existing tools often fail to capture all dimensions of health literacy—particularly its interactive and critical aspects—and may inadequately account for cultural and systemic variations. The rise of digital health literacy adds further complexity, necessitating the continuous adaptation of measurement frameworks. Without culturally and technologically adaptive tools, assessing the effectiveness of interventions and making cross-context comparisons remain formidable tasks. In practice, the complexity of health systems, resource limitations, digital divides, and insufficient communication skills among healthcare professionals constrain the success of health literacy interventions. Institutional shortcomings—termed “institutional health illiteracy”—and a lack of patient-centered communication practices disproportionately burden individuals, exacerbating existing inequities. While technological solutions hold promise, they may unintentionally deepen inequalities if digital proficiency and access are not equitably addressed. This study argues for rethinking health literacy through a holistic lens. Future research should adopt interdisciplinary, culturally responsive, and contextually aware frameworks, incorporating system-level reforms and organizational strategies that prioritize patient-centered care. By expanding beyond individual-level interventions and integrating structural and organizational considerations, health literacy efforts can more effectively promote health equity, improve patient outcomes, and support sustainable healthcare systems. In doing so, health literacy can evolve into a more robust tool for advancing social justice in health, facilitating patient empowerment, and ultimately enhancing public health on a broader scale.