The Action Network on Measuring Population and Organizational Health Literacy (M-Pohl), launched in February 2018 under the auspices of the WHO Europe-European Health Information Initiative (Ehii), aims at carrying out comparative surveys collecting, periodically, high quality data on the level of health literacy in the adult population of European countries. Together with several European countries, also Italy joined the network nominating the National Institute of Health (ISS) as the scientific reference and the Ministry of Health as the political reference.

 

This initiative starts from a previous experience, the European health literacy survey (Hls-Eu), conducted in 2011 in eight countries: Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain (n=1000 persons for each country; n=8000 persons for the total sample). Data collection was based on the example of the Eurobarometer survey and on the implementation of the Hls-Eu-Q questionnaire administered through face-to-face interviews assisted by computer or paper. The survey defined four levels of health literacy: insufficient, problematic, sufficient and excellent.

 

Data show that at least 1 out of 10 respondents (12%) showed insufficient health literacy and almost 1 out of 2 (47%) showed limited health knowledge (insufficient or problematic); however, the distribution of limited HL resulted basically different between countries (percentages ranging from 29% to 62%). Furthermore, some population subgroups (defined by financial deprivation, low social status, low educational level or old age), had higher prevalence of people with limited health literacy, suggesting the presence of a social gradient.

 

A low level of health literacy represents an important challenge for health policies and practices across Europe, but with different extent for different countries. For this reason, the social gradient in the culture of health must be taken into consideration when developing public health strategies aimed at improving health equity in Europe. Within the M-Pohl network, it is suggested to contribute with high quality international comparative data on health literacy.

This general objective should be supported by the following specific objectives:

1. to conduct a European, regular, reliable and transnational survey on health literacy, according to the Eurobarometer survey or to the Health Behavior in School-aged Children-Hbsc model (internationally coordinated collection of data on individual health literacy based on the population of several countries in the European Region). The project implies the identification of a European coordination center with the aim of maintaining and increasing the quality level which is essential for comparative research
2. to encourage the establishment of an international research consortium to support the survey coordination center, to recruit participating countries, to continuously maintain and improve the standards and quality of investigations, and to further develop the theoretical framework of the survey, the tool and methods of the survey, and the coordination of collection, analysis and reporting of international data in line with the agreed standards
3. to report, disseminate and discuss the results of health literacy in Europe, including explanations of the differences observed between countries and of changes over time at individual level and in the general population; in the future, to measure also the level of literacy of health organizations and systems
4. to develop an international multilevel database on health literacy (covering both the literacy of populations and that of health organizations)
5. to support health policies and practices based on evidence collected in the field of health literacy, providing explanations and making recommendations, and encouraging the international exchange of knowledge and experience on national policies and interventions in the field of health literacy, including advice for WHO European Office on the development of concrete annual work plans for health literacy
6. to recommend strategies for monitoring and evaluating health literacy initiatives
7. to stimulate research on in the relevant areas of health literacy, outlining the needs for further research.

To find out more, consult the pages dedicated to:

• health literacy
• the cross-sectional study "Health Literacy population-based survey-Hls19"