Gender and leadership for health literacy to combat the epidemic rise of noncommunicable diseases

When women win, we all win-Call for a gendered global NCD agenda

Gender is a social determinant of health, interacting with other factors such as income, education, and housing and affects health care access and health care outcomes. This paper reviews key literature and policies on health disparities and gender disparities within health. It examines noncommunicable disease (NCD) health outcomes through a gender lens and challenges existing prevailing measures of success for NCD outcomes that focus primarily on mortality. Chronic respiratory disease, one of the four leading contributors to NCD mortality, is highlighted as a case study to demonstrate the gender gap. Women have different risk factors and higher morbidity for chronic respiratory disease compared to men but morbidity is shadowed by a penultimate research focus on mortality, which results in less attention to the gap in women's NCD outcomes. This, in turn, affects how resources, programs, and interventions are implemented. It will likely slow progress in reducing overall NCD burden if we do not address risk factors in an equitable fashion. The article closes with recommendations to address these gender gaps in NCD outcomes. At the policy level, increasing representation and inclusion in global public health leadership, prioritizing NCDs among marginalized populations by global health societies and political organizations, aligning the gendered global NCD agenda with other well-established movements will each catalyze change for gender-based disparities in global NCDs specifically. Lastly, incorporating gender-based indicators and targets in major NCD-related goals and advancing gender-based NCD research will strengthen the evidence base for women's unique NCD risks and health outcomes.

Building health literacy system capacity: a framework for health literate systems

The human and social implications of poor health literacy are substantial and wide-ranging. Health literacy represents the personal competencies and organizational structures, resources and commitment that enable people to access, understand, appraise and use information and services in ways that promote and maintain good health. A large-scale societal improvement of health literacy will require political buy-in and a systematic approach to the development of health literacy capacity at all levels. This article builds the case for enhancing health literacy system capacity and presents a framework with eight action areas to accommodate the structural transformation needed at micro, meso and macro levels, including a health literate workforce, health literate organization, health literacy data governance, people-centred services and environments based on user engagement, health literacy leadership, health literacy investments and financial resources, health literacy-informed technology and innovation, and partnerships and inter-sectoral collaboration. Investment in the health literacy system capacity ensures an imperative and systemic effort and transformation which can be multiplied and sustained over time and is resilient towards external trends and events, rather than relying on organizational and individual behavioural change alone. Nevertheless, challenges still remain, e.g. to specify the economic benefits more in detail, develop and integrate data governance systems and go beyond healthcare to engage in health literacy system capacity within a wider societal context.

Functional Health Literacy in Patients with Cardiovascular Diseases: Cross-Sectional Study in Ethiopia

OBJECTIVE

This study assessed functional health literacy and associated factors among adult patients with cardiovascular diseases (CVDs) in Ethiopia.

METHODS

A cross-sectional study was conducted on 410 respondents from May 1 to July 1, 2020, using a functional health literacy questionnaire consisting of 14 items that covers three conceptually distinct functional health literacy domains: having sufficient information to manage my health, ability to find good health information and understand health information well enough to know what to do. Data were analyzed using the Statistical Package for Social Sciences (SPSS) Version 23. Data were collected by exit face-to-face interview using an interviewer administered and pre-tested questionnaire. Statistical significance of associated variables had been declared based on the adjusted odds ratio (AOR) with its 95% CI and p-value <0.05.

RESULTS

Adequate functional health literacy was determined in 55.4% of CVD patients understanding health information whereas inadequate functional health literacy was determined in 53.9% participants for finding health information and in 50.5% of them having sufficient information to manage my health. Educational status was found to have a statistically significant association across the three domains.

CONCLUSION

The functional health literacy level of CVD patients varied by domain. Educational status of the participant is significantly associated with the three domains of functional health literacy whereas household monthly income and number of information sources are significantly associated with having sufficient information and the ability to find good health information. The findings indicate the need to streamline medical communication that improves the functional health literacy of CVD patients.

Research on food-related chronic diseases in Latin America and the Caribbean: Are we building the evidence for gender-equitable approaches?

OBJECTIVES

Gender continues to be largely neglected in the global response to the noncommunicable disease epidemic. The objectives of this study were to examine current practice and barriers faced by Latin American and Caribbean (LAC) researchers in addressing gender in research on healthy food environments, and to identify future topics for gender-sensitive and gender-transformative research.

METHODS

This study involved: 1) a descriptive, three-part survey to investigate to what extent LAC researchers are integrating gender considerations in research for healthier food environments and 2) a participatory workshop to coproduce ideas for future gender-sensitive and gender-transformative research.

RESULTS

Fifty-four participants, from 19 countries, attended the workshop. Of those 54, 41 of them responded to at least one section of the three-part survey, including with 26 of the 41 responding to the section on gender. Of these 26, 17 (65.4%) had collected sex-disaggregated data and 14 (53.8%) had conducted gender analysis in recent research on food environments. Few participants had integrated gender-related findings in their recommendations and solutions. Challenges included data and methodological limitations (e.g., lack of preexisting evidence, working with secondary data), knowledge and capacity gaps, subject sensitivity, and biases. Participants identified research topics for enhancing gender equity that included food preparation norms and domestic responsibilities; differential participation of women and men in food production, distribution, and retail; and employment and school policies.

CONCLUSIONS

The findings from this study suggest that gender inequity is not being well addressed in food environment research from the LAC region. The analytical framework presented here can serve as an important starting point and resource for catalyzing future gender-transformative research. Complementary efforts are needed to overcome other challenges raised by the participating researchers, including capacity gaps, resource and data limitations, and publishing barriers.