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Introduction

EUPHA’s Strategy highlights that many health challenges we face today are of a global nature and magnitude, which is why the Strategy works towards achieving the United Nations Sustainable Development Goals (SDGs). Since the adoption of health literacy in the European Commission’s ‘Together for Health’ strategy in 2007 and the acceleration of the agenda by the European Health Literacy Project (HLS-EU) [1], health literacy has evolved into an important area of European public health research, practice and policy [2–4] contributing to the SDGs.

Health literacy enables people to access, understand, appraise, and apply health information in order to make informed decisions about health care, disease prevention and health promotion [5]. Health literacy is both a cross-cutting topic touching upon many public health areas that are addressed by EUPHA and an interdisciplinary field of research, sharing intersections with various other concepts and approaches within health, education, informatics, behavioral and social sciences [6]. As a concept and practical tool, health literacy has developed into an important public health strategy, exemplified by the many health policies focused on health literacy within European countries [7] and the inclusion of health literacy as a mandatory component of health education in selected national curricula [8].

Recent studies conducted by health literacy research communities, such as M-POHL [9] and the COVID Health Literacy Network [10], demonstrate that low health literacy is associated with adverse health outcomes and reinforces health disparities. In this context, health literacy can act as determinant, moderator and mediator of health throughout the life-course [1, 11, 12]. Improving population health literacy is key to improving health behavior, health outcomes and well-being. Investing in health literacy saves money, time and resources [13]. Supporting the health literacy of organizations, institutions and authorities can contribute to user-friendly, person-centred services and environments as well as health information and health communication based on people’s needs [14].

The COVID-19 pandemic has revealed that investing in the health literacy of health workers is a key strategy for supporting their interactions with patients and managing their own needs to protect themselves, their families, and their communities [15]. The COVID-19 pandemic and its associated ‘infodemic’ (the questions, concerns, confusion and lack of information which impacts people’s health behaviors) have stressed the societal need for a health-literate health system to build trust within populations, especially in times of crisis [16]. In health emergencies, more than in other times, people are faced with uncertainty, worries and a lack of reliable information, including mis- and disinformation, which collectively can lead to lower adherence to public health and social measures and a lower acceptance of and demand for vaccines, diagnostics and treatments [15, 17]. In this context, health literacy has been shown to be a tool in the management and mitigation of the COVID-19 pandemic and part of the portfolio of longer term strategies to prevent harm from epidemics and infodemics, as well as for building resilience of individuals and communities in the face of future health crises.   

Aims

The EUPHA Working Group on Health Literacy aims to:

  • Facilitate and promote the latest research, best practice examples and measures, training and education opportunities in academic and non-academic fields, and policy action related to health literacy
  • Endorse capacity building and sustainable development of the professional field of health literacy, including further literacy concepts relevant to health, and access to and use of health information by individuals

In particular, we will endorse interaction among the members, foster their collaboration, and at the same time serve as a European communication and network hub to promote and strengthen the role of health literacy. This includes addressing the capacity of (human) producers, users or mediators of health information, and the designed information environment that influences how people access, search for, receive, process, feel about and act on health information.

We understand health literacy as intersecting with many of the core topics and themes of EUPHA’s Sections, which is why collaboration and exchange with the Sections is essential to our overall strategy. Finally, our Working Group will engage in outreach and communication with networks, associations, agencies, and governmental and non-governmental organizations to represent the topic of health literacy from the perspective of EUPHA.

Working group members

The working group is established in April 2022. The members are:

  • Orkan Okan (chair), Department of Sport and Health Sciences at Technical University Munich (TUM), Germany
  • Catherine L. Jenkins, London South Bank University (LSBU), UK
  • Tina D. Purnat, Infodemic Management in the Unit for High Impact Events Preparedness, Department of Epidemic and Pandemic Preparedness and Prevention at WHO, Switzerland
  • Kristine Sørensen, Global Health Literacy Academy, Denmark
  • Gill Rowlands, New Castle University, United Kingdom

References

[1]          HLS-EU Consortium. Comparative report of health literacy in eight EU member states: The European Health Literacy Survey (HLS-EU). 2012.

[2]          Kickbusch I, Pelikan JM, Apfel F, et al. (eds). Health literacy: the solid facts. Copenhagen: World Health Organization Regional Office for Europe, 2013.

[3]          World Health Organization. Shanghai Declaration on promoting health in the 2030 Agenda for Sustainable Development. WHO.

[4]          The Economist Intelligence Unit. Health literacy around the world: policy approaches to wellbeing through knowledge and empowerment. Perspectives from The Economist Intelligence Unit (EIU), https://eiuperspectives.economist.com/healthcare/health-literacy-around-world-policy-approaches-wellbeing-through-knowledge-and-empowerment (2021, accessed 29 July 2021).

[5]          Sørensen K, Van den Broucke S, Fullam J, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 2012; 12: 80.

[6]          Okan O, Bauer U, Levin-Zamir D, et al. International handbook of health literacy: research, practice and policy across the lifespan. Bristol: Policy Press, https://policy.bristoluniversitypress.co.uk/international-handbook-of-health-literacy (2019, accessed 8 April 2019).

[7]          Rowlands G, Russell S, O’Donnell A, et al. What is the evidence on existing policies and linked activities and their effectiveness for improving health literacy at national, regional and organizational levels in the WHO European region? Copenhagen: WHO Regional Office for Europe, http://www.ncbi.nlm.nih.gov/books/NBK525689/ (2018, accessed 22 August 2019).

[8]          World Health Organization. Health literacy in the context of health, well-being and learning outcomes – the case of children and adolescents in schools. Concept paper. Copenhagen: WHO Regional Office for Europe, https://www.euro.who.int/en/health-topics/Life-stages/child-and-adolescent-health/publications/2021/health-literacy-in-the-context-of-health,-well-being-and-learning-outcomes-the-case-of-children-and-adolescents-in-schools-the-case-of-children-and-adolescents-in-schools-2021 (2021, accessed 9 September 2021).

[9]          HLS19 Consortium of the WHO Action Network M-POHL. HLS19 Consortium of the WHO Action Network M-POHL (2021): International Report on the Methodology, Results, and Recommendations of the European Health Literacy Population Survey 2019-2021 (HLS19) of M-POHL. Vienna: Austrian National Public Health Institute, https://m-pohl.net/sites/m-pohl.net/files/inline-files/HLS19_International%20Report%20%28002%29_0.pdf (2021).

[10]        Dadaczynski K, Okan O, Messer M, et al. Digital Health Literacy and Web-Based Information-Seeking Behaviors of University Students in Germany During the COVID-19 Pandemic: Cross-sectional Survey Study. J Med Internet Res 2021; 23: e24097.

[11]        Stormacq C, Van den Broucke S, Wosinski J. Does health literacy mediate the relationship between socioeconomic status and health disparities? Integrative review. Health Promot Int 2019; 34: e1–e17.

[12]        Pelikan JM, Ganahl K, Roethlin F. Health literacy as a determinant, mediator and/or moderator of health: empirical models using the European Health Literacy Survey dataset. Glob Health Promot 2018; 25: 57–66.

[13]        Institute of Medicine (IOM) of the National Academies. Health Literacy: A Prescription to End Confusion. Washington, DC: National Academies Press, 2004.

[14]        Farmanova E, Bonneville L, Bouchard L. Organizational health literacy: review of theories, frameworks, guides, and implementation issues. Inq J Med Care Organ Provis Financ 2018; 55: 46958018757848.

[15]        Paakkari L, Okan O. COVID-19: health literacy is an underestimated problem. Lancet Public Health; 0. Epub ahead of print 14 April 2020. DOI: 10.1016/S2468-2667(20)30086-4.

[16]        Sørensen K, Levin-Zamir D, Duong TV, et al. Building health literacy system capacity: a framework for health literate systems. Health Promot Int 2021; 36: i13–i23.

[17]        Okan O, Messer M, Levin-Zamir D, et al. Health literacy as a social vaccine in the COVID-19 pandemic. Health Promot Int. Epub ahead of print 12 January 2022. DOI: 10.1093/heapro/daab197.