Global Health Diplomacy:
Promoting Multisectoral actions in
Health Literacy
United Nations
ECOSOC Annual Ministerial Review
Beijing, China
29-30 April 2009
Scott C. Ratzan, MD, MPA
Vice President, Global Health
Government Affairs & Policy
Johnson & Johnson
Our Goal: Health for the public good
“The extension to all peoples of the
benefits of medical, psychological and
related knowledge is essential to the
fullest attainment of health.”
World Health Organization
Preamble to the Constitution
Developing Health Literacy
The Opportunity to Advance Health:
Health Literacy for the public good
“Informed opinion and active cooperation
on the part of the public are of the utmost
importance in the improvement of health of
the people.”
World Health Organization
Preamble to the Constitution
Apply our evidence-based
approach to Health Literacy
• Over 14 years of research in
the peer reviewed Journal
of Health Communication
had measurable outcomes
with communication
affecting:
–
–
–
–
–
–
–
–
Knowledge
Attitudes
Awareness
Practices
Perceptions
Intentions
Behavior change, and
Social Change
健康认知能力理论架构
Health Literacy Framework
技能/能力
Skills/Ability
需求/复杂性
Demands/Complexity
健康认知能力 - Health Literacy
健康认知能力是“个人获取，处理，
并了解基本的健康信息和服务以
作出适当的关于自身健康决定的
能力及其发展程度。”
Ratzan (作者本人)和帕克，美国国立医学图书
馆完整目录医学， 2000年
美国卫生与社会服务部 (USDHHS) ，健康人民
2010年
美国医学研究院， 2006
Health Literacy is “the degree to
which individuals have the
capacity to obtain, process,
and understand basic health
information and services
needed to make appropriate
health decisions.”
Ratzan and Parker, NLM/NIH
Current Bibliographies of
Medicine, 2000
USDHHS, Healthy People 2010
Institute of Medicine, 2006
Measure Health Literacy
A broad set of factor that empower and facilitate health
““what gets measured gets done”
• Incorporate health literacy with measurable
•
items
Link to global, regional and national efforts
to measure health quality, disparities, and
cost
健康认知能力平衡计分卡
Health Literacy – A potential scorecard
1.
2.
3.
什么我们如何保持健康？

关键领域和数字：免疫接
种，血液水平（血糖，胆
固醇） ，体重，血压等
如果我们生病了，我们怎样才
能做得更好？

你可以做质量自我照顾;
筛选吗？

你依赖于系统的健康决定
吗？
如果我们的生活与疾病，我们
如何获得有效的医疗护理？

知识，信息和实践
1.
What do we do to stay
healthy?
–
2.
If we are sick, how can we get
better?
–
–
3.
Key areas and numbers:
immunizations, blood levels
(glucose, cholesterol), weight,
blood pressure, etc.
Can you do quality self care;
screening?
Do you rely on the system for
health decisions
If we are living with illness,
how do we get effective
medical care?
–
Knowledge, information and
practice
儿童健康认知能力
Consideration of Pediatric health literacy
• “大多数儿童及其看护人
[可以]受益于一套健康的
识字技能足以应付共同预
防需要（如营养，发展，
家居安全，远见和领导检
查，预防接种。 ）
• 常见的急性健康需求（如
发烧，脱水，上呼吸道感
染，性传播感染）
来源：贝纳尔德雷尔，美国儿科学会，
2009年
• “Most children and their
caregivers [could] benefit from
a set of health literacy skills
adequate to meet common
preventive needs (e.g nutrition,
development, home safety,
vision and lead screening,
immunizations.) AND
• common acute health needs”
(e.g. Fever, dehydration, upper
respiratory tract infections,
sexually transmitted infections)
Source: Benard Dreyer, American Academy
of Pediatrics, 2009
亚太和中国版本健康知识平衡计分卡
Not an Easy Task for Asia Pacific
亚太和中国版本健康知识平衡计分卡 An
Illustrative Health Literacy Scorecard:
Asia Pacific
1.


1.


1.

什么我们如何保持健康？
关键领域和号码：身体质量指
数的范围，矿产/盐，免疫接
种，体重，血压等
我或我的家人/朋友抽烟？
如果我们生病了，我们怎样才
能做得更好？
我可以承认和理解符号/症状？
我什么时候寻求保健服务工作
者提供意见？
如果我们的生活与疾病，我们
如何得到有效的医疗护理？
知识，信息和实践
1.
What do we do to stay healthy?
–
–
2.
If we are sick, how can we get
better?
–
–
3.
Key areas and numbers: body
mass index in range,
minerals/salt, immunizations,
weight, blood pressure, etc.
Do I or my family/friends smoke
cigarettes?
Can I recognize and understand
signs/symptoms?
When do I seek a health service
worker advise?
If we are living with illness, how
do we get effective medical care?
–
Knowledge, information and
practice
Can we develop an approach for health
literacy?
CONCLUSION..
Efforts to impact health literacy requires multisectoral actions
Government
Health Ministry, Public Health
Officials, State and local
governments
• Legislation and policy
• Direct funding
Medical sector and research institutions
Academic institutions, physician
associations, individual doctors
• Testing and patient diagnosis
• Appropriate treatment and care
• Disease management
- hospital and pharmaceutical firms
• Research
- epidemiology
- scientific and clinical
- social
International health associations and
organizations (UN, WHO, World
Economic Forum, etc)
• International standard setting
- guidelines, protocols
- best practice
• Technical assistance
• Funding
• International coalition building
A Health
Foundations, NGOs
• Financial support
• Grass roots intervention
- initiate and sustain community action
• Lobbying and advising government
• Service delivery
Literate citizen
and world
Mass media and mobile technologies
Press outlets (TV, Radio, Newspaper,
Magazine)
Telecom outlets ( Message boards, SMS etc.)
• Public forum and information
- data dissemination
- public feedback and discussion
Private sector
Funding, individuals
• Corp. employee engagement education and financial support
• Corp in-kind support
• Innovation and creativity
Possible engagement with the
United Nations and health literacy - 2009
ECOSOC Outcome Report at
General Assembly for action under
provisions of a resolution on
“Global Health and Foreign Policy”
(September 2009)
ECOSOC Meeting on Promoting Health Literacy
(Beijing, 29-30 April 2009)
+
ECOSOC Meeting on NCDs in the Middle-East
(Qatar, 10-11 May 2009)
+
ECOSOC High Level Segment on Global Health
(Geneva, 6-8 July 2009)
UN General Assembly
High Level Discussion on Health
(New York,June 2009)
WHCA
Monograph
(September 2009)
Advancing health literacy on
multiple levels is ideal for health
diplomacy later this year
“Health is, I believe, a fruitful –
and a friendly – arena for foreign
diplomacy.
Health operates as a key driver
of economic and social
progress.
Health contributes to stability
and is a foundation of
prosperity”
解释：凡事要忍耐、包容一点，如果一点小事不
能容忍，将坏了大事。 *
A little impatience will
spoil great plans,
or
Patience is a virtue.
*小不忍则乱大谋。
《论语》the Analects of
Confucius
Thank You!
APPENDIX/BACKUPS
中国公共医疗卫生的总体目标
The overall goal of Public Health Care in China
(Excerpt from “Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System
Reform”)
the combination of
• 注重预防、治疗、康复三 • emphasize
prevention, treatment and
者的结合
rehabilitation
• 到２０１１年，基本公共
卫生服务得到普及
• 到２０２０年，人民群众
健康水平进一步提高。
• By 2011, the basic public health
services shall have been
available far and wide
• And by 2020, the health level of
the people shall be further
enhanced.
建立覆盖城乡居民的基本医疗卫生制度
Establishing the basic health care system covering urban and rural residents
(Excerpt from “Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform”)
• 加强健康促进与教育。医疗
卫生机构及机关、学校、社
区、企业等要大力开展健康
教育，充分利用各种媒体，
加强健康、医药卫生知识的
传播，倡导健康文明的生活
方式，促进公众合理营养，
提高群众的健康意识和自我
保健能力。
•
Efforts should be made to strengthen
health promotion and education. Health
care institutions, government agencies,
schools, communities, enterprises, etc.
shall massively carry out health
education, take full advantage of
various
media,
strengthen
the
dissemination of medical and health
knowledge, advocate healthy and
civilized lifestyle, promote rational
nutrition among the public, and enhance
the health awareness and self-care
ability of the people.
完善体制机制，保障医药卫生体系有效规范运转
Establishing practical and shared health care information system
(Excerpt from “Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform”)
• 建立健全医药卫生法律
制度。完善卫生法律法
规。加快推进基本医疗
卫生立法，明确政府、
社会和居民在促进健康
方面的权利和义务，保
障人人享有基本医疗卫
生服务
• Establishing and improving
health care legal system Efforts
should be made to improve the
health legislation. Quicken the
promotion of the basic health
care legislation, specify the
rights and obligations of
government, society and
residents in terms of enhancing
health to ensure that everyone is
entitled to the basic health care
services.