Up to one-fifth of Czech schoolchildren aged 13–15 do not know their way around health issues. They do not understand instructions from their physicians. They are unable to assess the health information they come across. Children are also often unaware of the effects of lifestyle on their own health. These findings are based on the data from an international HBSC study coordinated by a team from Palacký University Olomouc.
Adolescents aged 13–15 can be divided into three categories in terms of health literacy. One-fifth of them (18.2 percent) are at a low level; the largest group of schoolchildren (63.2 percent) is aware of health issues at a medium level. Another roughly one-fifth of children (18.6 percent) are very good at getting information on health, understanding it, and applying it. A slightly higher percentage of health illiterates was observed among boys (20 percent of boys vs about 16 percent of girls).
Health literacy affects health as well as lifestyle
The differences in the degree of health literacy are directly reflected in the health status of adolescents. Schoolchildren with lower scores in health literacy show significantly worse results in practically all compared criteria. Various aspects of physical and mental health were questioned – such as psychosomatic problems, the risk of depression, and overall satisfaction in life.
“Children with lower levels of health literacy have low statistical scores in other indicators too. The relationship between low literacy and eating habits is striking,” says Michal Kalman, head of the research team at UP. Children in this group eat little fruit and vegetables and often skip breakfast. The study also notes that they drink energy drinks more often. There is also a strong link between health illiteracy and physical inactivity or lack of sleep.
These children are twice as likely to get drunk repeatedly or experiment with marijuana, and even three times more likely to smoke regularly.
Socio-economic status, i.e. the economic security of the family, is another key to understanding all levels of health literacy. A quarter of the better-off schoolchildren have a high level of literacy (25.2 percent compared to 15.9 percent in less affluent families). At the same time, the level of health literacy does not differ fundamentally with respect to the size of the municipality where the children come from, i.e. the difference between urban and rural areas is not evident.
Children and pandemics?
The findings of UP researchers are highly topical in the context of the Covid-19 pandemic. Health information and the ability to deal with it in a relevant way can have a significant impact on the course of such events.
“This type of data can help us understand how young people really are. How they behave. How they are able to react to the current situation. Or how to prepare them for similar threats in the future,” Deputy Minister of Health Alena Šteflová said, emphasising the importance of the concept of health literacy. From the very beginning, the ongoing epidemic required constant public encouragement for increased hygiene and adherence to guidelines for controlling the spread of infectious diseases. “I believe that this was positively reflected in the awareness of everyone, including the child population,” added Šteflová.
Srdan Matić, a representative of the WHO in the Czech Republic, also considers the data obtained within the international HBSC study to be extremely important: “Health literacy is one of the long-term priorities for the WHO. This initial study gives us a great insight into the current state of health literacy among Czech children. In addition, we have data for comparison from several other European countries.” According to Matić, the proven significant relationship between health literacy and health status is a sufficient basis for specific projects aiming to increase the level of health literacy among children and youth in the Czech Republic.
In addition to that, the topic of health literacy is expected to become one of the key areas of research in the next data collection for the HBSC study. The impact of the ongoing pandemic on the lifestyle of teenagers will be also researched.
Health literacy in Czech schools
These were one of the reasons why a set of informative educational materials was created for immediate use in Czech schools. It is based on the latest findings of Olomouc researchers, complementing them with specific recommendations and teaching activities with an emphasis on 11–15-year-olds. The activities can also be adapted for other age groups.
“The materials have a print component, but a large part of the information is available online. Some of its proposed activities rely on the remote fulfilment of tasks. It reflects the current situation not only thematically, but also by the means used to achieve the ends. This is exactly the type of project that we quickly supported in the context of the Covid-19 pandemic,” concludes Petr Konvalinka, Chairman of the Technology Agency of the Czech Republic.
The team from Palacký University Olomouc has been monitoring and commenting on factors influencing the health of Czech schoolchildren aged 11, 13, and 15 on a long-term basis. A total of 230 schools took part in the current research on the level of health literacy; more than 9,000 children provided their answers. For more information, see the Zdravá generace?! (Healthy Generation?!) website.
The HBSC (Health Behaviour in School-aged Children) study is developed in collaboration with the World Health Organization (WHO). It comprehensively deals with the lifestyle of the young generation. In addition to recent data on health literacy, it also focuses on physical activity, obesity, and eating habits, alcohol consumption, smoking and marijuana consumption, and drinking sugary and energy drinks. In addition to the Czech Republic, forty countries from all over the world are involved in the study. You can learn more about the study at www.hbsc.cz.