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Wisdom, Health Literacy & Equity

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03 September 2026

Posted:

04 September 2026

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Abstract
To aim for health equity, this essay posits the necessity of lifelong health literacy education for all individuals. A fundamental aspect of this endeavour involves prioritizing wisdom, characterized by intellectual and emotional intelligence, and encapsulated by the principles of realism, benevolence, and creativity. To elucidate the multifaceted, theoretical and practical concept of wisdom, it is essential, first, to cultivate intellectual intelligence. This entails comprehending the world objectively, based on verifiable evidence and rational, logical reasoning, rather than on perceived desires. This necessitates humility in search of truth and a clear-eyed acceptance of reality. Furthermore, wisdom incorporates emotional intelligence, which involves the capacity to manage one's own emotions and those of others, thereby preventing emotions from dictating one’s responses. Emotional intelligence thus encompasses social awareness (particularly empathy) and effective relationship management, promoting respectful interactions and collaborative problem-solving to foster dignity and health for all. Another defining characteristic of wisdom is creativity, which involves critical thinking, curiosity, and innovation across art, science, and literature. Crucially, it involves appreciating the beauty and wonders of the world, identifying and avoiding potential pitfalls or “traps”, such as psychological biases, sociocultural pressures, ecological challenges, evolutionary traps, and AI-delegation traps (i.e., over-reliance on artificial intelligence). Ultimately, this essay contends that genuine health literacy—the ability to appropriately access, understand, appraise, and utilize health information and services—can only be achieved through the integration of these principles of wisdom. This holistic approach is crucial for reducing preventable health disparities and advancing the overarching goal of health equity.
Keywords: 
health equity
;  
literacy
;  
wisdom
;  
intellectual intelligence
;  
emotional intelligence
;  
beauty
;  
creativity
;  
(intellectual/emotional) “traps”
Subject: 
Public Health and Healthcare  -   Health Policy and Services

Introduction

The 21st century is characterized by the fourth industrial revolution, which heralds a series of sociocultural, economic, environmental and political upheavals to people all over the world. Driven largely by the combined forces of digital, physical, social, biological, and medical innovations, human lives have undergone unprecedented changes this century. While many benefits have been accrued to many users of these technologies, others have not—or have even been victimized. Thanks to digital technologies and labour-saving automation, innovations based on smarter and more powerful machines make our lives easier, more comfortable and more convenient. For example, a GPS (Global Positioning System) on smartphones could guide us where to go, so we don’t get lost; AI Overview could answer almost any question instantaneously without us heading to a library for answers in encyclopedias. On the other hand, many phishing scams are going on by telephone or on the internet, so it is a miracle not to fall victim to their clever schemes; UNESCO’s “Behind the Screen” survey [1] revealed that 62% do not carry out rigorous and systematic fact-checking of information before sharing it with others. And yet, 73% express the wish to be trained to do so.
Clearly, it is important to learn how to navigate safely through the turbulent waters which we are bound to encounter at times during our life’s journeys. That requires wisdom, which encompasses and synthesizes intellectual intelligence, emotional intelligence, and creative innovations, in order “to show the fly the way out of the fly-bottle”—the metaphor Ludwig Wittgenstein [2] used to describe the aim of (his) philosophy. Health literacy— “being able to access, understand, appraise and use information and services in ways that promote and maintain good health and well-being” [3]—shows us the way towards health equity, a key aspect of the wisdom needed to achieve optimal health for all.
The purpose of this paper, therefore, is to investigate and elucidate the concepts of wisdom, health literacy, health equity, and their relationships.

What are Health and Health Equity? Why are they Important?

To avoid confusion, let me begin with key definitions. “Health” is primarily a characterization of an individual like you and me, and only by extension, of a collective such as “the health of a nation.” Thus, although the definition of health as “a state of complete physical, mental, and social well-being, rather than merely the absence of disease” [4] is widely acclaimed, health is primarily used to characterize an individual as a mind-body unity, so that it is best to define health as “a state of physical and mental well-being.” The social factors, being external to an individual, are the most important determinants of his/her health. That is why they should be treated as integral to the definition of the health of a collective, such as a community or a nation [5].
Unlike ‘equality in health,’ an empirical concept, ‘equity in health’ is a normative concept. While the former aims to eliminate all disparities in health between individuals, the latter only aims to eliminate avoidable health disparities for all individuals. Unavoidable health disparities are expected to persist at different levels—as no two individuals have the same genetic endowment and life experiences. The goal of health equity, therefore, is to provide all necessary support (including social, educational, medical, and technical, etc.) to help every individual achieve the best attainable level of health [6].
Health equity is humanity’s overarching goal, because having the best possible health is the foundational engine for flourishing beyond survival. Health is indeed a fundamental human right, as proclaimed by the World Health Organization.

Causes of Health Disparities

There are a host of indications that we are far from achieving health equity. As the World Report on Social Determinants of Health Equity [7] pointed out, the following health disparities, due largely to social determinants of health equity, are “avoidable”, “preventable”, and therefore, “unfair”:
The place where you live, the communities you belong to, your education level, ethnicity, race, income and gender, and whether you have a disability, all make a huge difference to how long you can expect to live a healthy life. People in the country with the highest life expectancy will, on average, live for 33 years more than those born in the country with the lowest life expectancy. There are major differences in life expectancy between countries at very similar income levels: data shows that regardless of income level, some countries have managed to halve premature death over the past half-century, while in others, it has remained the same or even increased. Within countries, life expectancy varies by decades, depending on which area you live in and the social group to which you belong.
The report concluded:
In the pursuit of prosperity, countries have too often failed to integrate equity and fairness into policies. Globally, we have also failed to integrate an appreciation of intergenerational equity, further undermined by the existential threats of climate change, war and conflict.
The agenda to address the social determinants of health equity is necessarily broad and can feel like a call to achieve “everything, everywhere, all at once”. But this complexity must not be an excuse for inaction. Practical actions as outlined in this report will deliver improvements in health equity, and communities, governments, thinkers and leaders are already showing the way forward. Seizing on their example, and knitting together disparate efforts into a comprehensive strategy of action, will be of immense benefit to all of humanity for generations to come.
It should be noted, however, that the impact of socioeconomic status varies across racial and ethnic groups [8], so that a more nuanced approach is required in the design of practical actions.

Health Literacy: What is it? What Factors Influence it? Why is it Important?

Health literacy, according to the World Health Organization [3], is defined as:
…representing the personal knowledge and competencies that accumulate through daily activities, social interactions and across generations. Personal knowledge and competencies are mediated by the organizational structures and availability of resources that enable people to access, understand, appraise, and use information and services in ways that promote and maintain good health and well-being for themselves and those around them.
A recent systematic review [9] of studies on health literacy published between 2018 and 2024 showed that,
a)
50% to 80% of participants in high-income settings had adequate health literacy; and
b)
Up to 40%, most commonly reported in low-and-middle-income countries, had inadequate health literacy.
Not surprisingly, therefore, health literacy was influenced by:
a)
Educational attainment: Higher education levels correlated positively with health literacy across all studies.
b)
Gender: Women generally exhibited higher health literacy levels than men.
c)
Age: Middle aged adults tended to have higher health literacy than their younger (17-34) or older (65+) adults.
d)
Language: Participants assessed in their native language showed better health literacy outcomes.
Furthermore, Sudirman [10] conducted a comprehensive survey of peer-reviewed studies to examine the impact of health literacy on preventive behaviours, stating:
Findings indicate that individuals with higher health literacy are more likely to engage in health-promoting behaviors, utilize healthcare services, and effectively manage chronic diseases. In contrast, those with lower health literacy experience higher health risks due to limited access to and understanding of health information.
The study highlights the effectiveness of community-based education programs, digital interventions, and culturally tailored strategies in improving health literacy.

Wisdom for Health Literacy & Equity

Wisdom, in simple terms, is the skill of knowing both the ultimate goal of human flourishing and the practical steps to reach it. It relates the why (why do you live, or what is your purpose in life?) and the how (how do you live, or how sound are your choices in life?) of your being. Without both, true success is impossible. Thus, a wise person is motivated to live well, knows how to live well, and in fact lives well without many unjustified beliefs—as detailed in the “hybrid Theory” section of the Stanford Encyclopedia of Philosophy. Because no individual is an island unto himself/herself, wise persons seek solutions that benefit not only themselves but also others and the larger society as well [11].
A broad metacognitive definition of wisdom is characterized by the following worldview:
that accurately reflects the world as it is, where the key to wisdom development is the continued learning of how the universe operates, through which individuals come to understand human cognitive ability as limited compared to the complexity of their subjects of interest, as “change” is the defining characteristics of the universe. Adapting to this experience, the metacognitive features of wisdom, represented by humility and flexibility, become the universal hallmarks of wisdom [12]
Mascolo [13] further presents an intersubjective view of wisdom, stating that,
The rigorous study of “wisdom” must be beyond a mere empirical analysis of “what is” and acknowledge the role of human values in defining what we take to be instances of wise activity.
While contemporary literature emphasizes the realistic and moral dimensions of wisdom [11,14], there is a burgeoning need to incorporate a third dimension: beauty [15]. The classical triad of Truth, Goodness, and Beauty suggests that these ideals are fundamentally intertwined. In this integrated framework, wisdom utilizes Truth as its foundation, Goodness as its ethical guide, and Beauty as its inspiration to pursue a more meaningful existence.
From the perspective of wisdom, therefore, the issue of health disparities may be a concern (i.e., unethical) if such disparities are avoidable, and some people may not achieve better health than they potentially could. And this seems to be the case with more disadvantaged and vulnerable populations. They tend to have lower levels of health literacy and poorer health. Wisdom dictates, however, that with appropriate help they could excel—as had been the case, e.g., for blind, deaf and mute Helen Keller (1880-1968), who believed:
that the poor were "ground down by industrial oppression", so she wanted children born into poor families to have the same opportunities to succeed that she had enjoyed. She wrote, "I owed my success partly to the advantages of my birth and environment. I have learned that the power to rise is not within the reach of everyone."
(Wikipedia)
To realize the ideal of eliminating unfair, avoidable, and remediable health disparities, we need to level the playing field by providing all necessary social support to promote health literacy, for all of us to reach our optimal health and well-being.

A Call for Action: Towards Health Literate Canada

The goal of health equity is to ensure that all of us have adequate social and financial support to pursue optimal health and well-being, given our potential at birth. To level the playing field and, in particular, to help the socioeconomically disadvantaged, indigenous and migrant populations, the following action plan is called for:
  • A universal, guaranteed livable basic income (GLBI)
A vast amount of literature, including my own research [6,16,17,18], shows that low socioeconomic status is associated with low levels of health literacy and access to preventive and curative healthcare services. While it is desirable to undertake the complex issue of reducing wealth and income disparities, it would be more feasible to eliminate poverty and ensure that everyone has a sufficient income to live a healthy and decent life, if motivated to do so.
While most proposed GLBI programs are for income enhancement with “no strings attached,” no country has implemented it due to concerns such as work disincentives, prohibitive costs, risk of inflation, etc. In Canada, Senator Kim Pate [19] has introduced Bill S-206 to call for all levels of government and numerous non-government organizations to show the multi-jurisdictional support and collective need for GLBI across Canada:
The guaranteed livable basic income envisioned by the bills would work alongside, not replace, vital health and social supports such as medicare, pharmacare, dental care, housing and labour protections, access to education, and other financial supports such as those available to responding to particular needs of Indigenous Peoples, those with disabilities, seniors and others.
Such a program should be designed to ensure that only those whose incomes are below the GLBI receive additional cash, after the annual income tax return, so their incomes equal the level set for the GLBI. The program should also be designed to enhance not just income but also quality of life—to empower those who need psychosocial counselling and/or job training and employment opportunities.
Why? Veronika Scott’s story is instructive. She started at age 24 with The Empowerment Plan, a Detroit-based non-profit. She experienced homelessness herself, so while she was a college student, she designed a coat for the homeless. And yet when she tried to give a coat to the homeless, she was confronted by a woman who angrily told her, "I don't need a coat":
Instead, the woman demanded a job. This four-word realization shifted Scott's mission entirely. Rather than just handing out garments, she built an organization dedicated to hiring and training homeless women to manufacture the coats themselves, providing them with financial independence and a way out of poverty [20].
It was through such experiences that she gained practical wisdom to help the homeless, which required empowering everyone not only to meet short-term physical needs but also longer-term mental and social challenges. Indeed, meaningful employment or engaging in meaningful activities are necessary for good health and a happy life.
2.
Universal Healthcare Insurance Coverage
Having a GLBI for everyone is necessary, but not sufficient. To achieve health equity, it is also necessary for everyone to access all preventive and curative healthcare services, as needed. For example, Canada has a universal health care system which ensures all eligible residents have reasonable access to medically necessary hospital and physician services without out-of-pocket charges, fully funded through general taxation; and between 2023-2025, the Canadian Dental Care Plan and the national Pharmacare Act came into effect.
By contrast, approximately 8% (26-30 million) of the U.S. population lacks health insurance, and millions more remain underinsured, facing severe out-of-pocket deductibles relative to their incomes. It is not unusual to read a story of financial catastrophe such as this [21]:
I’m an educator with horrible insurance. I’ve always lived paycheck to paycheck. I’m 49, and two years ago had a massive heart attack that killed one third of my heart muscle. I’m now on 13 medications daily and must go to a heart transplant specialist at $1,200 per visit. I have maxed out my credit cards and will soon be filing for bankruptcy. This week, I’m hiding my car because it’s about to be repossessed. My medical bills have destroyed my life, but if I stop my prescriptions or doctor visits I’ll die. –R. James
Having universal health coverage is necessary but still insufficient, since access to healthcare is influenced by socioeconomic status even in Canada with reasonable universal health insurance coverage [18]. Therefore, we need to broaden our search for ways to meet health equity goals.
3.
Health Literacy
Having a guaranteed livable basic income (GLBI) is critical, enabling us to engage in lifelong learning and to educate ourselves on how to live a healthy life—i.e., to gain the know-how to live well, avoid getting sick or injured, and promote and adopt healthy lifestyles. I was therefore impressed when I read a book by the indigenous educator, Pansy Collison [22], who wrote about the Haida way of education:
When children did wrong, the first thing we did was to provide examples of their behavior and give the children an opportunity to make better choices. We use the power of storytelling to show the right way. If children are disobedient, rude to an Elder or doing things, which might be dangerous to themselves, then they would be told one or more stories designed to show what happens to those who misbehave. I think it is no exaggeration to say that all American Indian stories, when used in the right context, can serve as lesson stories and as important tools of communication.
Such an educational philosophy should be the foundation of lifelong learning throughout everyone’s journey in life, no matter how young or how old. As Collison [22:210] stated:
Our lives and journeys are riddled with trials and tribulations. Life can be very unfair at times when you make mistakes. You may feel distraught, shattered, and overwhelmed, but making a mistake will not destroy your life. Learning is a lifelong process; we all learn something new everyday.
Indeed, lesson-stories, self-reflections, as well as psychological counselling, philosophical counselling, etc., if helpful, should be readily available and accessible to anyone at any time who is undergoing difficult times in this ever-changing world, to deal with emotional and existential problems and traumas, and to uphold personal dignity and wellbeing [23].
The reality, however, is that our societies are riddled with many disparities in health literacy. In Canada, for example, 9 million people have limited literacy skills [24], with over half of Canadians below a high school reading level [25]. And yet, Canadian literacy, numeracy and adaptive problem-solving skills were above the average of the 27 Organization for Economic Co-operation and Development (OECD) countries in 2022 [26]. Canadians, moreover, do not always trust scientific studies: while 11% of respondents said they always trust claims based on scientific studies, 47% of respondents said they usually trust claims but still want to consider other sources, while 3% said they don't trust scientific evidence at all; thus, 43% of Canadians are highly susceptible to believing misinformation, while another 35% are moderately susceptible—according to the 2025 Health and Media Tracking Survey commissioned by the Canadian Medical Association [27].
More specifically, according to the Canadian Council on Learning [28], an estimated 60% of Canadian adults (age 16 and older) and 88% of seniors (age 65 and older) have limited health literacy. Since health is strongly influenced by health literacy, the following actions are recommended to improve health literacy:
  • Cultivate daily reading-listening habits
Canada has one of the most highly educated populations in the world, yet 60% of Canadian adults lack adequate skills to manage their health and health-care needs.
For example, while adults aged 16-65 who frequently engage in activities such as reading books, newspapers, magazines, websites, social media, email exchanges, etc., can score up to 38% higher than the average in health literacy, those aged over 65 can score up to 52% higher than the average for their age. Hence, “reading each day helps keep the doctor away.” Hence, daily reading habits have been shown to have the strongest effect on health-literacy proficiency [28].
  • b. Nurture reflective and critical thinking
In the age of mass information exchanges, moreover, everyone must appraise the truthfulness and reliability of all pieces of information. This is because a great deal of social media reports are mis-, dis-, or fake information, often phishing and scamming you for their financial gains. To be health literate not only means acquiring the skills to seek and disseminate relevant health-related information, but also to differentiate reliable and useful from unreliable or useless information.
For instance, it has been reported that 17-20% of the Canadian population explicitly state that they refuse to get the seasonal flu shot for fear of adverse side effects or harm [29]; and 43% of Canadian adults mistakenly believe that the flu vaccine can give them the flu [30]. Wisdom dictates that such unfounded, misleading beliefs should be rejected, and a wise action is to get the appropriate flu vaccine at the beginning of each flu season to minimize the spread of the flu in the population.
The most important step in critical thinking is to double-check the information source, seek peer-reviewed evidence, double-blind clinical trials, and beware of emotionally charged marketing language. Thus, the safety and effectiveness of vaccination are supported by leading health authorities, such as the World Health Organization, the U.S. Food and Drug Administration, and the Public Health Agency of Canada. Sources that advise against vaccination or question its efficacy, on the other hand, generally rely on retracted studies, unverified databases, personal anecdotes, or philosophical and religious objections rather than reproducible scientific evidence [31].
  • c. Embed Health Literacy into School Curricula and Lifelong Learning Programs
Health literacy is gained through lifelong learning. Thus, it should be embedded in all levels of our educational system—in primary, secondary, adult education, and elder college curricula and programs—and delivered in plain medical and healthcare language suitable for participants’ age and cultural backgrounds.
This appears to be a viable approach according to a scoping, systematic review of current literature [32]. Thirty-seven (37) interventions, mostly published between 2020 and 2025, to advance health literacy in educational settings were identified. Twenty-nine targeted elementary and secondary school students, while fewer focused on teachers, counsellors, school personnel, or university students. All studies reported improved health literacy-related outcomes. Thus, educational institutions may advance health literacy through curriculum-based strategies to promote health literacy and improve student and staff outcomes.
  • d. Fund Public Forums to Address Timely Health Literacy Concerns
Public policies regarding health literacy to provide accurate and timely information is critical for ensuring personal and social health. Regular news release and public forums with credible media reporting are essential to address ongoing health concerns. In this regard, it is incumbent upon government health agencies, university health and medical faculties, professional associations to organize public forums and media reports to inform and educate the public, and encourage them to be more active in disseminating accurate and timely health-related information.
An example of this approach is the Saskatchewan Aboriginal Grandmothers Caring for Grandchildren Support Network Program. Organized by the University of Regina Lifelong Learning Centre, partnered with First Nations University of Canada’s Regina Qu’Appelle Health Region, Aboriginal grandmothers, grandchildren and other family members meet monthly to discuss their strategies, successes and concerns about health and wellbeing. It is “a network of Aboriginal women caring for children and extended family members who are in a unique position to contribute to the advancement of health and wellbeing in their communities. The network provides a safe and supportive environment in which the participants can gain knowledge about healthy lifestyles and share their personal experiences of being caregivers. The program serves to bridge gaps in health knowledge by bringing in guest speakers to present culturally-relevant health information through traditional teachings. The network uses therapeutic talking circles as a way for participants to share experiences and gain new knowledge on healthy aging and healthy living.” Verbal feedback is sought by Lifelong Learning staff to ensure the program meet the needs of the participants [33].
Thus, the goal of equity in health literacy would require a comprehensive, “inter-sectoral approach” that involves all levels of government and cooperation of many public and private sectors to educate the general public through lifelong learning [34]. It is a challenge that civil society must undertake for the well-being of humanity.

Concluding Remarks

Promoting health through health literacy is an arduous yet necessary public policy in Canada and other countries, particularly among socioeconomically disadvantaged and migrant populations. Addressing these disparities requires targeted policies that ensure income safety and psychological-occupational counselling, universal healthcare and public health insurance for everyone, and health-literacy initiatives and daily reading habits, discussions and reflections through public forums, education systems and lifelong learning practices.
Future research should explore innovative interventions and standardized assessment tools to enhance the effectiveness of health literacy programs. Strengthening health literacy is essential for reducing health inequities, enhancing preventive care, and improving overall population health.

Funding Information

None.

Author Contributions

Wei-Ching Chang is the sole author, who did the research, composed the article, proofread and edited, and finalized the paper.

Conflicts of Interest

None.

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