Exploring Networked Health Literacy

Beyond individuals and organizations

Health literacy is a top priority in US public health, as evident in its central place within Healthy People 2030. Today, "health literacy" covers two main focus areas: personal and organizational. "Networked health literacy" presents a way to think about connecting the two. And to think beyond them, which is key in an increasingly complex media environment.

What is personal health literacy?

This aspect of health literacy focuses on people's skills. How well do you follow these instructions? How much of this pamphlet do you understand? Health professionals might gauge this by giving someone a test like the Short Assessment of Health Literacy. Healthy People 2030 defines "personal health literacy" as:

the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions...

What is organizational health literacy?

This aspect of health literacy focuses on institutional policies and practices. How consistently do providers use evidence-based communication practices with their patients? How clear are the educational materials they provide? Health literacy professionals might assess this via a tool like the HLE2. Healthy People 2030 defines "organizational health literacy" as:

the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions...

What is a networked public? And why does it matter for health communication?

A networked public is a social space enabled by web technologies and the people who use them. (Credit to danah boyd for this idea.) You can identify a networked public by three features: friends list, profiles, and mass communication tools. This includes social media that encourage audience building, like LinkedIn and Instagram. It also includes more community-focused apps like Discord.

This is an important concept for public health, because it illustrates an everyday dynamic of social media. We regularly communicate at a scale that is neither individual nor organizational yet encompasses them both. Networked publics point to the need for health literacy research & practice beyond these scales too. They raise further critical questions for health communication on social media. How do offline events affect conversations on each platform? How do your messages travel to other spaces?

Organizational and personal health literacy do not suffice to strategically engage with networked publics. Given how intertwined many people's social lives are with social media, this raises questions about the need to think beyond individuals and organizations for in-person communication too.

What might "Networked Health Literacy" be?

I want to propose a version of health literacy that is suitable for networked publics and the way they intersect with more familiar audiences like patients, families, and communities. In a networked public, you don't fully know who your audience is. You don't have control over where your message travels. You don't know what other messages will surround your own. Equitable health communication in this context involves more than an individual set of skills or a set of organizational practices focused on understandable information.

I propose "networked health literacy" as a way to think about health literacy beyond individuals and organizations. In short, it describes the collaborative use of networked technologies to advance health equity. It involves more than just knowing how to post on a platform. It involves more than just plain language. It involves navigating the social dynamics of each platform and their interactions with people's offline social lives. Importantly, it incorporates individuals and organizations while leaving room for other kinds of audiences.

Conclusion (for now): What can "Networked Health Literacy" offer you?

I think it's important to recognize that health literacy in the social media involves more than just individual skills and organizational practices to support information uptake. It also involves leveraging technological features you have little say in. It involves collaboration in an increasingly decentralized media environment.

I'd like to end this article with a few observations on networked publics and next steps for health communicators.

• People interact with media in many different ways. So, learn how to make your messages more accessible.
• Messages don't stay in one place. So, make more bitesize messages. You may not cover as much at once, but you also reduce the risk of misunderstandings when a screenshot gets taken out of context.
• Online messages are searchable. So, figure out how other people are talking about the issues you care about. Find out how your intended audience encounters for the kind of content you create.
• Media highlight connections between online and offline spaces. So, learn more about in-person events that local businesses and influencers advertise online. This can help you understand more about the ways online communication impacts in-person social life in the communities you serve.

Keep in mind: "networked health literacy" is not a formal framework (yet). It is a work in progress to integrate valuable knowledge from the field of health literacy with knowledge from media studies and the humanities. I hope this new series in Health Literacy Right Now is part of a broader conversation about how to improve health communication in the pandemic era.

About the author

Sam is a PhD candidate in Population Health Sciences at the Harvard T.H. Chan School of Public Health. Their research combines media studies and computational social science to help expand the scope of health literacy research. Outside of research, their work focuses on supporting social media communication that can help advance health equity.