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Background: Schools are seen as crucial environments to influence and develop the health literacy of new generations, but without sufficient reflection on the ethical underpinnings of intentions and interventions around health literacy. In contrast, we argue here that ethics are fundamental to all education. The article adopts a 'One world' approach that generalizes broadly across the so-called Global North and Global South. It also generalizes across various age groups among school pupils, advocating age appropriate application of the arguments advanced., Main Text: Our analysis examines why health literacy should be promoted in schools and argues that the purpose should embrace the values of social justice and should not stop at individual and national cost benefit analysis. Discussion about the orientation of health literacy highlights meta-cognitive skills around critical thinking, self-awareness and citizenship rather than lists of practical skills. Finally, approaches to health literacy in classrooms are presented with an ethical tone that draws attention to the power relations responsible for health inequities and that does not assume that such power relations are the given framework for health literacy interventions and activities. These arguments are reinforced by urging that related debates address dynamic social realities such as international migration., Conclusions: We reiterate the need for ethical questions to be consciously and systematically addressed from early on, beginning with intentions to promote health literacy even before these intentions are translated into action, within the political space where education meets public health and health promotion. We underline again the context of fluidity and dynamism, as new challenges emerge within pedagogies and curricula, especially in response to changing populations in the society around.

Background: Health literacy (HL) is an important determinant for maintaining and improving health throughout the lifespan. This underlines the need to monitor HL, including among adolescents, and to understand the factors explaining HL, with a view to decreasing differences in HL. The aim of this study was to objectively measure HL, and the relationship between HL and socio-demographic factors (gender, language of instruction, pupils' educational aspirations, parents' educational background and pupils' school achievement) among pupils (n = 3652) at the end of basic education in Finland. Methods: A nationally representative assessment, which included 55 items on HL, was conducted as a traditional paper-and-pencil test in schools. The data were analysed via descriptive statistics and a two-level hierarchical linear model to determine how the socio-demographic factors affected HL. Results: The pupils' average score on the HL test items was 58.9%, indicating a satisfactory HL level. A two-level hierarchical linear model showed that the variables (gender, language of instruction, pupils' educational aspirations, parents' educational background and pupils' school achievement) predicting the HL level had statistically significant effects. Conclusions: Among ninth graders (15–16 years old), almost one third of the boys and 8% of the girls exhibited an unsatisfactory HL level. The study also confirmed the importance of school-related factors in explaining HL differences. Since low HL has been linked to several unfavourable health indicators and has been viewed as an underestimated problem in times of pandemic and other health crises, the findings suggest that the HL level of Finnish ninth graders is a clear public-health issue. [ABSTRACT FROM AUTHOR]

Health literacy (HL)—as a broad range of health-related competencies—has been proposed to be a promising construct in understanding health disparities better, also among adolescents. Several factors have been found to explain differences in adolescents' HL levels; however, not much is known about how different regions of a country or majority/minority status is associated with HL, or whether HL is associated with regional health disparities. The aim of this study was to examine and compare HL and health levels among majority- and minority-language-speaking adolescents living in different regions of Finland, and to explore if HL explains regional health disparities, taking into account other important structural stratifying factors. The study uses Health Behaviour in School-aged Children survey data, collected among 13- and 15-year-old pupils in Finnish- and Swedish-speaking schools in Finland in 2014 (N  = 3853/1123; 85/83%). Findings suggest that regional differences in HL levels and regional health disparities exist in both language groups. Health disparities were present in the Finnish-speaking sample among boys, the proportion rating their health as excellent ranging from 23 to 31% across regions, and in the Swedish-speaking sample among girls, the corresponding numbers ranging from 13 to 20%. In addition to other important structural stratifying factors, comprehensive HL explains these regional health disparities. This study adds to prior studies on the role of HL as a modifiable health resource by showing that regional health disparities among adolescents can partially be attributed to corresponding HL differences. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore Finnish adolescents’ subjective health literacy (HL) in association to school achievement, learning difficulties, educational aspirations, and family affluence.Design/methodology/approach Nationally representative data were collected in Finland as a part of the international Health Behaviour in School-aged Children study. The respondents consisted in total of 3,833 adolescents (7th and 9th graders) from 359 schools. The Health Literacy for School-aged Children instrument was applied to measure adolescents’ subjective HL, while the Family Affluence Scale was used to measure adolescents’ socioeconomic status. Information was gathered on school achievement, learning difficulties, and educational aspirations.Findings Approximately one-third of the adolescents manifested a high level of HL, around 60 per cent had a moderate level of HL, and about one-tenth had low HL. The HL level was lower for boys than for girls, and lower for 7th graders than for 9th graders. In the total sample, the strongest explanatory variables for HL were school achievement in the first language, and educational aspirations.Originality/value This study provides the first nationally representative examination of adolescents’ subjective HL levels, and how these vary across age and gender groups. In drawing conclusions and presenting suggestions for HL interventions, it is important to verify the nature of the HL examined in any given study, and how it was researched. [ABSTRACT FROM AUTHOR]

Only a few countries have introduced health education (HE) as a stand-alone school subject. In Finland every pupil in basic education grades 7–9 takes three obligatory courses in HE. This study investigated Finnish pupils’ perceptions of the teaching and learning of HE. It also explored how school- and family-related background variables are associated with these perceptions. Nationally representative data were obtained from a 2010 school-based study on Health Behaviour in School-aged Children (HBSC). A total of 4262 pupils from 7th and 9th grades (13 and 15 years old) responded anonymously to the questionnaire. Logistic regression analysis was performed to identify the associations between perceptions of HE and school- and family-related background variables. The majority of the pupils had positive perceptions of HE. In terms of their own learning, girls’ perceptions were more positive than boys’: 86% of 13- and 15-year-old girls agreed that HE classes had taught them to think about the advantages and disadvantages of various health behaviours, whereas only 79% of boys shared this opinion. School engagement had the strongest association with perceptions of HE: the more positive the attitudes towards school, the more positive were the perceptions of HE. Older girls perceived their learning and their participation in class discussions more positively than younger ones, and older boys were more critical of the teaching than younger ones. The pupils’ educational aspirations were not associated with their perceptions of HE, and perceived family affluence was associated only with girls’ perceptions of participation in HE classes. The pupils’ feedback on HE was positive and encouraging. There is a demand for the subject in society, and HE seems to have the potential to augment young people’s positive attitudes towards health issues, and to enhance their health literacy. [ABSTRACT FROM PUBLISHER]