SPECIAL REPORT / People who are well-versed in health issues make better lifestyle choices, avoid developing chronic diseases and lead longer lives. But with health literacy varying greatly across the EU, campaigners are calling for action from politicians.

A new consensus paper on how to advance health literacy in Europe was launched on Friday (4 October) at the European Health Forum in Gastein, Austria.

It shows that 47% of the population in eight European countries are estimated to have insufficient levels of health literacy.

According to the paper, health literacy can be understood as "people's knowledge, motivation, competencies to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve quality of life during the course".

The joint document was developed by a broad policy coalition comprising the pharmaceutical giant MSD, the European Patients' Forum (EPF), the Standing Committee of European Doctors (CPME) and Maastricht University.

In the eight countries surveyed – Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain –, 41% of respondents showed limited levels of literacy related to healthcare.

Some 43% had difficulties grasping the notion of disease prevention and 51% struggled with health promotion – or the ability to advance one's own health.

Wake-up call

People with higher health literacy levels are less likely to develop chronic diseases and make healthier lifestyle choices. They are usually more adherent to treatment and tend to lead longer lives.

At the same time, high or low health literacy levels also have an impact on the efficiency of healthcare systems, said participants at the Gastein health forum.

Kristine Sørensen from the Maastricht University’s European Health Literacy practice, said that the consensus paper was a wake-up call for policymakers, but also for people in the medical professions. She said the policy coalition had already met with the European health commissioner, Tonio Borg, to discuss an EU strategy on health literacy as a cross-cutting issue.

While there are marked differences in levels of health literacy between countries, there are also great differences within states, according to the consensus paper.

Certain groups within the population are at greater risk – for example the elderly, people with low levels of education or socio-economic status, as well as those who report suffering bad health.

Limited health literacy has wide-ranging consequences, experts say. People with poor health literacy are hospitalised more often, are more likely to take inappropriate treatment or prescriptions and are less inclined to take preventative measures.

Alexander Rödiger, director of EU affairs at MSD, said a high level of health literacy was good for patients, but also beneficial for society at large as it contributes to making healthcare systems more efficient.

More education

Sylvain Giraud, head of unit for the European Commission’s health and consumers directorate (DG Sanco), said that the health literacy dimension was "very important" as surveys had shown that a 30-year old man who had completed university studies could expect to live 17 years longer than a 30-year old man who had not continued with education.

"This probably means that the best way to improve health literacy would be to invest a lot in education and invest a lot in social care,” Giraud stated.

Karin Kadenbach, an Austrian MEP (Socialists and Democrats), said that although she was the former health minister of Austria, she had sometimes found it difficult to find the right doctor, treatment and information.

“When I was the health minister, I tried to better communicate. I sometimes saw that we spent a lot of money on topics, on communication that didn’t reach the people that really should be reached.

“It makes no sense to produce a lot of brochures or to have a lot of material in a hospital and though we say literacy, this is not just about letters, but also pictures and pictograms," she said.