Empowerment through understanding: helping policy-makers improve health literacy across all societal levels

The 57th HEN report: “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?”

Health literacy is the capacity of individuals, families and communities to make sound health decisions in the context of everyday life. It is a critical competence for increasing people’s control over their health, empowering and enabling them to seek out health information and express themselves on health issues. Health literacy is also a key element for the achievement of Health 2020, the European health policy framework, and the Sustainable Development Goals.

To support national policy-makers in their efforts to improve health literacy, a new Health Evidence Network (HEN) synthesis report has been published. It highlights evidence of effective health literacy policies from across the WHO European Region.

The new report is entitled “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?” WHO/Europe’s Division of Information, Evidence, Research and Innovation (DIR) developed the report in collaboration with the Division of Noncommunicable Diseases and Promoting Health through the Life-course. The Swiss Federal Office of Public Health provided financial assistance.

The report is the 57th issue in the HEN synthesis report series. It gathers evidence from Member States across the Region, identifying 46 health literacy policies and strategies. It shows that 19 Member States recognized low health literacy as an issue and were either in the process of developing, or had developed, policies to address it. The health literacy policies focused on a number of interlinked sectors and societal levels, and included a wide range of activities analysed according to the new Health Literacy Policy Model.

The report also describes how activities aiming to improve health literacy were evaluated, and reports on the effectiveness of activities with beneficiaries across individual, community, organization and system levels.

Based on the literature, facilitators of successful health literacy policy implementation include intersectoral working, supportive institutional structures and processes, political leadership, community participation, and networking. Embedded cultural beliefs, which may influence individuals to adopt healthier lifestyles, can also be factors in the implementation of health literacy policies.

Policy considerations

The HEN report highlights good practices and emerging evidence of effectiveness of health literacy policies for individuals and communities, but also shows that policies could benefit from a more holistic approach.

It concludes by proposing the following policy considerations.

  • Consider the existing policies and related activities gathered in the review to develop or enhance health literacy policies and related activities to benefit citizens, patients and communities.
  • Broaden the range of areas of activity required for holistic health literacy policies to include the lived environment, the workplace, the media and digital/electronic health, at all societal levels – individual, community, organization and system (legislative).
  • Strengthen the evidence base for the effectiveness of health literacy at all societal levels to ensure that policies address needs specific to the national or local context.
  • Incorporate robust qualitative and quantitative evaluations into health literacy policies and interventions – quantitative methods could include pre- and post-activity health literacy evaluations of evidence of health, social and economic effects at all levels.
  • Incorporate facilitators of successful implementation, such as intersectoral working, political leadership and strategies to overcome cultural barriers, into health literacy policy.

Relevance to evidence-informed policy-making

Evidence-informed policy-making is a core function of WHO/Europe. WHO/Europe works to ensure that the best available evidence is used to formulate national and regional policies and practices. To this end, the HEN Secretariat, located in the Knowledge Management, Evidence and Research for Policy-making Unit within DIR, produced this report.