How to be health literate

Health literacy refers to our ability and motivation to access health resources, interact with it (understand, evaluate, use) and thereby take ownership of health decisions that concern us (WHO, 1998, p. 10).  Our health behavioural decisions are influenced by our cultural and societal norms and expectations, as well as the economic and environmental structures within which we live.  Health literacy efforts must therefore utilize more than communication and education to bring about positive behavioural and attitudinal changes.


Why is it important to be health literate?

Health literacy applies to both disease prevention and disease care.  Being health literate enables us to:

  • Read, evaluate and make use of health-related information in magazines, television and radio programs, and brochures from health organizations
  • explain symptoms to medical professionals
  • discuss health concerns with medical professionals, such as disease risk factors, prevention and management strategies, side-effects of medication and the use of traditional and/or herbal remedies for treatment
  • understand and follow medical professionals’ recommendations
  • read medication labels and take the appropriate dosage
  • fill out health insurance forms

Being health literate is of benefit to us as individuals to make decisions about our own health and also to provide support and care for others, such as children and the elderly and to help them make health-related decisions.


Effects of low health literacy

Research across a range of cultural settings, ages and socio-economic demographics show that low health literacy is linked to:

  • Lower knowledge about the disease causes and effects
  • Lower knowledge about practical steps to prevent or manage the disease
  • Low self-rating of health status
  • Increased use of medical services
  • Patients with low health literacy are more likely to have severe disease associated complications and are more likely to need hospitalization.
  • For diabetics, poor health literacy is further associated with poor management of blood pressure and blood sugar levels and increased prevalence of retinopathy.


How to become more health literate

To become more health literate and thereby make better informed health-related decisions, you can:

Ask your health professional questions: your health is your priority, and if you are not sure about any aspect of your healthcare, you should ask

Ask your health professional to slow down if they are speaking too fast.  Similarly, ask them to speak up if they are speaking too softly.

Repeat what you have understood: health professionals sometimes use terms and phrases that are difficult for us to understand.  Tell your health professional what you understood and they can clarify if there is a misunderstanding.

Support yourself: If you are more comfortable in a language other than English, see if you could take an adult with you who could be your interpreter and also a support person.  You can ask (or have someone ask on your behalf) the health centre to organise a free interpreter for you.

Expand your support network: Ask your health professional for support groups and organizations that you could contact and have a wider support network.  Research shows that having a strong positive and empathetic support network can improve our confidence and outlook on life as well as contribute  to faster recovery from illnesses.


Research on health literacy consulted for this article

Centers for Disease Control and Prevention. Improving Health Literacy for Older Adults: Expert Panel Report 2009. Atlanta: U.S. Department of Health and Human Services; 2009.

Egbert, N., & Nanna, K. M. (2009). Health literacy: Challenges and strategies.The Online Journal of Issues in Nursing14(3).

Gazmararian, J. A., Williams, M. V., Peel, J., & Baker, D. W. (2003). Health literacy and knowledge of chronic disease. Patient education and counseling,51(3), 267-275.

Hewitt, M. (Ed.). (2011). Improving Health Literacy Within a State:: Workshop Summary. National Academies Press.

Improving Your Health Literacy. September 2010. Agency for Healthcare Research and Quality, Rockville, MD.

Kim, S., Love, F., Quistberg, D. A., & Shea, J. A. (2004). Association of health literacy with self-management behavior in patients with diabetes. Diabetes care27(12), 2980-2982.

Kutner, M., Greenburg, E., Jin, Y., & Paulsen, C. (2006). The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. NCES 2006-483. National Center for Education Statistics.

Nutbeam, D. (2000). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health promotion international15(3), 259-267.

Omachi, T. A., Sarkar, U., Yelin, E. H., Blanc, P. D., & Katz, P. P. (2013). Lower health literacy is associated with poorer health status and outcomes in chronic obstructive pulmonary disease. Journal of general internal medicine,28(1), 74-81.

Schillinger, D., Grumbach, K., Piette, J., Wang, F., Osmond, D., Daher, C., … & Bindman, A. B. (2002). Association of health literacy with diabetes outcomes. Jama288(4), 475-482.

World Health Organization (WHO) (1998) Division of Health Promotion, Education and Communications Health Education and Health Promotion Unit. Health Promotion Glossary. World Health Organization, Geneva

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Storytelling culture in the Pacific

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Strong Pacific focus for postdoctoral researcher

Pacific focus
Research focused: Farzana (left) with her mentor Julie Barbour (right).

Oceanic linguistics specialist Dr Farzana Gounder has been awarded a 2013 Postdoctoral Fellowship Award by the Faculty of Arts and Social Sciences which will allow her to dedicate a year to research focusing on narrative and identity constructions in the Pacific.

Strong Pacific research focus

The Fijian Indian was drawn to the University of Waikato because of its strong Pacific research focus, particularly within the Linguistics programme.

“Being a person from and of the Pacific, I have a strong passion for contributing to scholarly knowledge on the diverse and unique narrating features found within the Pacific region, an area that is research-rich, yet currently understudied,” says Dr Gounder.

Plans whilst at Waikato

During her one-year term here at Waikato, Dr Gounder will be focusing on editing a volume with John Benjamins, titled Performing Narrative Identities in Oceania in the prestigious Studies in Narrative (SiN) series. The book has attracted considerable interest, with both national and international contributors.

Dr Gounder will also be writing journal articles, a book chapter, speaking at national conferences and leading seminars and workshops at the University.

“This award has given me a wonderful opportunity to immerse myself in research. It’s stimulating to be part of such a strong culture, surrounded by people who are so passionate about their areas of expertise,” says Dr Gounder.

Her mentor is Dr Julie Barbour, an accomplished linguistics researcher who currently holds a Marsden grant to study the mood systems in the oceanic languages of Vanuatu.

FASS Postdoctoral Fellowship

The FASS Postdoctoral Fellowship is a one-year award funded by Strategic Investment Funds. The Fellowship aims to attract emerging international researchers and to provide pathways for completed PhD students to enhance their capacity to move into an academic career position.

The position attracted a large number of applicants drawn to particular research foci in units, centres or institutes within the faculty, and by the international profile of many of the research staff.

In carrying out research at the University of Waikato, Dr Gounder intends to build relationships with other researchers in oceanic studies on campus, nationally, and internationally for further collaborations.

“My research for the foreseeable future will be in oceanic linguistics, as the Pacific is where my own identity lies.”


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On Wednesday 1 February, IPC had great pleasure in celebrating the launch of a book written by one of its lecturers, Dr Farzana Gounder, as an outcome of her Doctor of Philosophy studies at Massey University. The event was attended by Farzana’s family, friends and colleagues as well as supervisors and colleagues from Massey University and the wider Palmerston North community.

The book, Indentured Identities, resulted from a book contract following the successful completion of Farzana’s PhD in late 2011. Dr Gounder explored the “themes of indenture, migration and identity formation” of cases taken from some 45,000 Indians who went to work in Fiji between 1879-1916, mostly on sugarcane plantations, and then chose to settle there. The book was published in USA.

One of Dr Gounder’s PhD supervisors, Dr Martin Paviour-Smith, commented that the book “has been published in the most prestigious series of books on narrative studies.” This came about when Professor Bamberg of Clark University (USA), “the leading expert on a particular kind of narrative analysis,” made contact to offer Dr Gounder a book contract. Dr Paviour Smith explained that narrative “is important to understand who people are and how they present themselves and what they do with their stories” and Indentured Identities succeeds in this respect.

In her book, Dr Gounder explains the childhood memories that led her to study the life narratives of the Girmityas:

“My journey with these Girmityas’ life narratives began when I was seven years old. In my earliest memories of visiting dādī, I see us all sitting, and listening, the Girmityas’ voices entering the house through the large speakers on either side of a silver rectangular box as we drink hot milky tea. The radio had pride of place in my grandmother’s living room, where the television now sits. We listened to the Girmityas recollecting their experiences, which they did with sometimes laughter, sometimes tears, and at other times with anger, bitterness, or resignation.

It was a time when Fiji Indians were searching to define who they were, a hundred years after the first Girmityas arrived in Fiji. As our family’s history with Fiji began with Girmit, we would listen to the life narratives with great interest, after which came the adults’ critique. This was the only time that I heard the life narratives, until I began this study twenty-one years later. But although I did not hear them again, the Girmityas’ narratives whispered to me through my memories”.

Farzana commented to the audience, “The theme of migration probably resonates with us all because either we ourselves are migrants or we are children or great grandchildren or grandchildren of migrants.”

Indentured Identities: Resistance and accommodation in plantation-era Fiji, published by John Benjamins Publishing Company, USA, 2012.

Dr Gounder is a Lecturer in the Bachelor of International Studies degree programme at IPC.



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Recent graduate publishing success Congratulations to Dr Farzana Gounder

Recent graduate publishing success
Congratulations to Dr Farzana Gounder

Dr Gounder who graduated last year with a PhD in linguistics, celebrated the publication of her first book, Indentured Identities: Resistance and Accommodation in Plantation-era Fiji this week. Joining the prestigious series, Studies in Narratives, Farzana’s doctoral work is sure to reach a wider audience. The Series editor Michael Bamberg was the external examiner who contacted Farzana on the day of her oral defence. Farzana’s book examines the narrative performance of the last Girmityas – or indentured labourers who arrived in Fiji in the decades around the turn of the 20th century to work the sugar plantations. Her analysis shows that Girmitya had a considerably wider range of responses to indenture than many historians will credit, and use narrative techniques strategically to foreground or down play their own roles, and abilities to influence the events around them at different times. The function at International Pacific College was well attended and it was great to see the many former and current students of School of Linguistics and International Languages Studies celebrating alongside Farzana’s success.

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