Conceptualisation of critical health literacy-insights from Western and East Asian perspectives: a scoping review.

This article describes a scoping review of components of critical health literacy (CHL) and examines how these components have been conceptualised, highlighting fundamental differences from the Western and East Asian perspectives. The review includes 23 studies, with the majority (n=19) from Western countries and only two from East Asia. Three primary components of CHL were identified: 'information appraisal', 'understanding of social determinants of health (SDH)' and 'actions to address SDH'. The findings indicate that these prevailing components of CHL are largely grounded in Western social structures, while East Asian studies primarily focused on the first component. Given the distinct social and cultural norms in these regions, this study explored the potential differences in how social factors influencing health are understood and prioritised in Western versus East Asian contexts. From a Western universalistic perspective, actions to address SDH often involve political and social movements aimed at improving individual and community health. However, such actions may not be feasible or relevant for many East Asian population groups, who may have more limited opportunities to engage in Western-style social movements, and culturally, have a stronger focus on family and local community. Furthermore, building on the theory of 'distributed health literacy', we argued that interpersonal-level actions to address SDH are also crucial and can serve as a stepping stone to social-level actions, which have been more extensively discussed in Western literature. We conclude that CHL is a context-specific concept, and its definition and practical application need further examination across different contexts.