(Re)framing Health Literacy: Transforming the Culture of Health in the Black Barbershop

Article excerpt

Literacy serves emancipatory functions when appropriated to reconstruct society and/or provide individuals with the options needed to participate in all sociocultural institutions. Literacy functions in an oppressive manner ... when curricular materials, educational philosophies, and pedagogical techniques combine to inculcate an ideology that denigrates a group, omits or misrepresents the history and status of a group, or limits access to knowledge that would enable the individual or group to participatein sociocultural institutions.

Harris, 1992

Alphabet literacy, the culture of schooling, and pedagogical structures of dominance, all have played a major role in the dialectical tension between oppression and resistance in the US. For African Americans, literacy remained an illusion of political, economic, and social equality enmeshed in historical realities from slavery to contemporary times of the twentieth century. As a tool to restrict and deny, literary acquisition served to contextualize the cultural biases of class and race dimensions. One of the distinctions between African Americans and Europeans, it was argued, was the act of writing. Gates (1985) notes:

   ... writing, many Europeans argued, stood alone
   among the fine arts as the most salient repository
   of "genius," the visible sign of reason itself. In
   this subordinate role, however, writing, although
   secondary to reason, is nevertheless the medium of
   reason's expression. We know reason by its writing,
   by its representations. Such representations could
   assume spoken or written form. And while several
   superb scholars give priority to the spoken as the
   privileged of the pair, most Europeans privileged
   writing--in their writings about Africans, at least--as
   the principal measure of the Africans' humanity,
   their capacity for progress, their very place in the
   great chain of being. (p. 9)

Individual identity and self-worth was framed within the ability or inability to read and write, thus defining African American identity as problematic in the Western idealism of literacy. Literacy was seen as a binary; privileging alphabet literacy over oral and other multiple ways of knowing. Implying that illiteracy constitutes failure of personal goals, social worth, and self-potential, also suggests an inability to acknowledge literacy as a multitude of practices that legitimize realities and communicate diverse and varied experiences. More to the point, envisioning a literacy that celebrates the Black illiterate in its wholeness in learning and teaching to read the world (Freire & Macedo, 1987) generates discourse that deepens our understanding of the dynamics and complexities of domination and begins to reframe public discourse on the nature of literacy. Kozol (1985) focuses the need to address illiteracy specifically within a discourse of race politics:

   When nearly half of all adult black citizens in the
   United States are coming out of public schools
   without the competence to understand the antidote
   instructions on a chemical container, instructions
   on a medicine bottle, or the books and journalistic
   pieces which might render them both potent and
   judicious in a voting booth, who can pretend that
   literacy is not political? (p. 92)

Poor health literacy skills create insurmountable barriers to fully understanding personal health, illness, and/or treatments. Evidence suggests that inadequate health literacy is a major barrier to educating patients, especially those with chronic illnesses, and hampers current efforts to overcome health disparities (Davis et al., 2006; Williams et al., 1998). In addition, participants who report lower education and lower literacy rates also demonstrate more likelihood of experiencing confusion over medications, greater emotional distress and depressive symptoms than do individuals of higher educational literacy. …