Health literacy on the European agenda

People with lower health literacy are less healthy, and are less able to take good care of themselves. This is true not only in the Netherlands, but all over Europe. Around the world, health literacy is increasingly being recognised as a crucial determinant of health, and is attracting more and more attention from researchers, politicians, and health care organisations. This has emerged from a study conducted for the European Commission by the EPHORT consortium, led by the Netherlands Institute for Health Services Research (NIVEL).

 
Although more and more European countries are giving health literacy the attention it deserves, most of them have not yet included this as a focal point of their national health policy. Only six European countries have formulated national objectives for health literacy skills, and the Netherlands is not among them. However, an inventory made by the researchers has shown that many countries have actually undertaken activities to either promote health literacy skills or to tailor health care to those with lower levels of health literacy. Because an in-depth evaluation still needs to be done for most of these activities, it is not yet clear how effective they are.
 
Tailoring
Even so, what has emerged from the studies carried out in Europe to date is that if activities are to be successful, they have to meet two conditions: initiatives should be tailored specifically to the needs of patients or groups with lower health literacy and not to patients in general, and they should focus on competencies and skills (such as communication and critical thinking) and not just on knowledge.
 
Self-confidence
According to NIVEL department head Jany Rademakers, “Health literacy is about more than just a person’s ability to read and understand health information. It also concerns motivation, self-confidence, and discernment. Are you able to tell your doctor you don’t understand something? When you have a prescription filled, what do you do if the information you get from the pharmacist is slightly different than what your doctor told you? Interventions need to address these important themes, and people could also use some help with this.”
 
Models
Many European countries would now like to know how things stand when it comes to the health literacy levels of their own populations. Because not all countries have the money for a survey, the study developed models that use publicly available population data to come up with reasonably accurate estimates of these levels.
 
Fragmentation
Rademakers: “This study shows that although health literacy is increasingly on the agenda in European countries, there is often no national policy in place to coordinate these activities. This results in fragmentation. More insight is also needed into the effectiveness of interventions and other efforts in this area.”
 
Funding
European Commission
 
Partners
EPHORT Consortium: NIVEL, RIVM en EPHA