About health literacy
Health literacy empowers people to make positive choices. It implies the achievement of a level of knowledge, personal skills and confidence to take action to improve personal and community health by changing personal lifestyles and living conditions. Thus, health literacy means more than being able to read pamphlets and make appointments. Health literacy is an enabler that supports the promotion of equity by improving people’s access to health information, and their capacity to use it effectively.
WHO believes in an inclusive view of health literacy, broadly defining it as “the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health”. The concept of health literacy has evolved significantly since its introduction, and now includes a complex and interconnected set of abilities.
Why health literacy is important
A high level of health literacy enables people to develop the skills and confidence to make informed decisions about their health and the health of their families, to be active partners in their care, to effectively navigate health-care systems, and to advocate effectively to their political leaders and policy-makers.
Health literacy responsiveness, sometimes called organizational health literacy, is another important factor. This is the way in which services, organizations and systems make health information and resources available and accessible to people, according to their health literacy strengths and limitations.
By empowering people and creating favourable environments, stronger health literacy and health literacy responsiveness drive forward equity in health outcomes by making health care accessible to all, regardless of individual abilities.
Shanghai Declaration: health literacy key to achieving the SDGs
Political calls for action recognize the investment needed for the development of health literacy. The Shanghai Declaration of 2016 recognizes health literacy as one of the key health promotion pillars for achieving the Sustainable Development Goal (SDG) targets. To realize these ambitions, actors on political, community and organizational levels must work together to integrate health literacy as a cornerstone of all national health agendas.
The large gaps in health literacy between and within countries in the WHO European Region contribute to significant health inequities, especially because health literacy challenges disproportionately impact vulnerable populations. Critical public health action to enhance health literacy and address this imbalance must be implemented.
Levels of health literacy vary widely across sociodemographic groupings in societies. Low health literacy has been associated with less healthy choices, riskier health behaviour, poorer health status, less self-management, and higher costs and inappropriate use of health services. Increasing health literacy empowers citizens through the development of personal and collective knowledge and skills, and the creation of responsive settings, healthy policies and enabling environments. Health literacy also helps in addressing stigmatization and presumptions caused by insufficient communication.
Policy-making based on a health literacy approach makes it possible to develop people-centred public health strategies and programmes, and contributes to achieving their goals and outcomes.
Impact of health literacy
Health literacy impacts health outcomes in a multitude of ways.
- High rates of health literacy in population groups benefit societies.
Health literate individuals participate more actively in economic prosperity, have higher earnings and rates of employment, are more educated and informed, contribute more to community activities, and enjoy better health and well-being. - Limited health literacy significantly affects health.
Limited health literacy is associated with less participation in health-promotion and disease-detection activities, riskier health choices, more work accidents, diminished management of chronic diseases, poor adherence to medication, increased hospitalization and rehospitalization, increased morbidity, and premature death. - Limited health literacy follows a social gradient and can reinforce existing inequalities.
People with limited health literacy most often have lower levels of education, are older adults, are migrants, and depend on various forms of pubic transfer payments. - Building personal health literacy skills and abilities is a lifelong process.
No one is fully health literate – everyone at some point needs help in understanding or acting on important health information. - Capacity and competence related to health literacy vary according to context, culture and setting.
These depend on individual and system factors, including communication skills, knowledge of health topics, culture, and the specific characteristics of health care, public health and other relevant systems and settings where people obtain and use health information. - Responsiveness of health systems facilitates achieving positive health outcomes.
The sufficiency of an individual’s level of health literacy depends on the responsiveness of organizations in health and other sectors, and the demands placed on the individual as a result of the complexity of the systems they must navigate.
Because of its role as a key determinant of health, health literacy must be an area of focus within political agendas.
