As we write our editorial for a health literacy special issue in the midst of the international COVID-19 crisis, we take this opportunity to highlight the importance of individual, community, and population health literacy. We are not only in a "pandemic" but also an "infodemic". Health literacy is more important than ever in the face of these global health threats, which have impacted outcomes across the levels of the socio-ecological model (SEM), including individual health behaviors, family relationships, organizational behavior, state policy-making, national mortality statistics, and the international economy in the span of weeks. Our special issue sought to pull together interdisciplinary threads guided by two principles. The first was defining health literacy as essential skills and situational resources needed for people to find, understand, evaluate, communicate, and use information and services in a variety of forms across various settings throughout their life course to promote health and wellbeing. The second was the idea that enhancing health literacy in populations and systems is critical to achieving health equity. In this time of public health need across traditional borders, the inter-sectoral and international perspectives of special issue articles are more urgent than ever. A greater understanding, appreciation, and application of health literacy can support policy action on multiple levels to address major public health challenges. Health literacy should be built deliberately as a population-level resource and community asset. We have summarized the set of articles in this special issue across the levels of the SEM, hoping their thoughtful considerations and interesting findings will help to support global health and wellness and inspire future research, policy, and practice in this global public health emergency and beyond.

https://www.mdpi.com/1660-4601/17/9/3010/pdf

Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19.

Migration, displacement and identity in post-soviet Russia

Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs.

Health care spending in the United States and other high-income countries

The COVID-19 pandemic mandating isolation, quarantine, and social distancing has accelerated and expanded the use of telemedicine. This study examines the extent of the use of telemedicine and the relationship between eHealth literacy and satisfaction with using telemedicine during the pandemic. A total of 156 participants from a clinic in a peripheral community in southern Israel completed an online questionnaire. We found that 85% knew how to use the internet for health information, but only one third felt safe using it to make health decisions. Furthermore, 93% used the internet for technical needs, such as renewing prescriptions or making a doctor's appointment. Even lower use for telemedicine was found (38%) for consultation or treatment sessions. A positive association was found between eHealth literacy and satisfaction variables with using telemedicine (rp = 0.39, p < 0.001). Although respondents understood the benefits of telemedicine, they were not satisfied nor interested in online sessions after the epidemic's end, preferring a meeting involving personal interaction. Young people and academics benefit more from telemedicine, thereby creating usage gaps and potentially increasing existing inequality. We recommend developing intervention programs, especially among vulnerable populations, to strengthen eHealth literacy and remove barriers causing skepticism about the use of telemedicine during and after the pandemic.

Telemedicine and eHealth Literacy in the Era of COVID-19: A Cross-Sectional Study in a Peripheral Clinic in Israel.

Large diasporas of former Soviet Union (FSU) immigrants are found in the USA, Germany, and Israel. To synthesize evidence, identify limitations, and propose future directions we conducted an integrative review on the health literacy of FSU immigrants, migrants, or refugees in four languages. Following integrative review and PRISMA guidelines, we searched four databases in English and performed supplementary searches in Russian, German, and Hebrew to identify qualitative and quantitative studies on FSU immigrants and health literacy. Six articles met inclusion criteria in English and one in German; the majority were published in the last five years. Only two articles measured health literacy of FSU immigrants, which was lower than the general population. Four articles were about immigrants with a mean age ≥50 years. All articles stressed the value of translated, culturally relevant health information. The health literacy of FSU immigrants is understudied, despite clear needs. Future research should include assessments of FSU immigrants’ health literacy and include diverse (e.g., age, gender) yet well-defined populations to determine both barriers and facilitators to their health literacy. This review, an example of a multilingual search, provided a comprehensive understanding of existing literature and is a useful approach for global health literacy research.

https://www.mdpi.com/1660-4601/18/2/657/pdf

A Multilingual Integrative Review of Health Literacy in Former Soviet Union, Russian-Speaking Immigrants.

Among the world's 272 million international migrants, more than 25 million are from the former Soviet Union (FSU), yet there is a paucity of literature available about FSU immigrants' health literacy. Besides linguistic and cultural differences, FSU immigrants often come from a distinct healthcare system affecting their ability to find, evaluate, process, and use health information in the host countries. In this scoping review and commentary, we describe the health literacy issues of FSU immigrants and provide an overview of FSU immigrants' health literacy based on the integrated health literacy model. We purposefully consider the three most common locations where FSU immigrants have settled: the USA, Germany, and Israel. For context, we describe the healthcare systems of the three host countries and the two post-Soviet countries to illustrate the contribution of system-level factors on FSU immigrants' health literacy. We identify research gaps and set a future research agenda to help understand FSU immigrants' health literacy across countries. Amidst the ongoing global population changes related to international migration, this article contributes to a broad-scope understanding of health literacy among FSU immigrants related to the system-level factors that may also apply to other immigrants, migrants, and refugees.

Cheryl L. Albright

Papers

International Perspective on Health Literacy and Health Equity: Factors That Influence the Former Soviet Union Immigrants.

A Multilingual Integrative Review of Health Literacy in Former Soviet Union, Russian-Speaking Immigrants.