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Improving health literacy to reduce health inequalities

Local action on health inequalities

1. The term ‘health literacy’ refers to people having the appropriate skills, knowledge, understanding and confidence to access, understand, evaluate, use and navigate health and social care information and services. Levels of health literacy are also influenced by the provision of clear and accessible health and social care services and information for all (service responsiveness).

2. Limited health literacy is linked with unhealthy lifestyle behaviours such as poor diet, smoking and a lack of physical activity and is associated with an increased risk of morbidity and premature death. People with limited health literacy are less likely to use preventive services and more likely to use emergency services, are less likely to successfully manage long-term health conditions and as a result incur higher healthcare costs.

3. An individual’s health literacy tends to be related to their social circumstances. Educational attainment strongly predicts good health literacy and people with limited financial and social resources are more likely to have limited health literacy. In turn, limited health literacy limits opportunities for vulnerable and disadvantaged groups to be actively involved in decisions about their health and care over the life course. This can undermine people’s ability to take control of their health and the conditions that affect their health.

4. Efforts to improve health literacy can have a range of benefits. They can increase health knowledge and build resilience, encourage positive lifestyle change, empower people to effectively manage long-term health conditions and reduce the burden on health and social care services.

5. The available evidence suggests that strategies to improve health literacy are important empowerment tools which have the potential to reduce health inequalities because the most vulnerable and disadvantaged people in society are at risk of limited health literacy and are known to have the poorest health outcomes.

6. Further large-scale, robust and clearly defined research is needed to better understand the effect of health literacy interventions on health inequalities. This should include research focused on how best to improve the health literacy of disadvantaged or vulnerable people, the effects of such initiatives on clinical and health outcomes over time and more research on cost-effectiveness.

7. Promising health literacy strategies to support people to take control of their, their families’ and their children’s health include:
- health and social care service use of the simple and effective teach-back method to check service user understanding
- an early intervention approach to health literacy – ensuring that promoting health literacy is fully integrated into early years and school curriculums, as well as in health and social care professional training
- community-based, peer-support approaches to health literacy that help to distribute health literacy among social networks
- empowering professionals through training, continued education and inter-disciplinary initiatives to improve health literacy and strengthen public–professional communications

8. Integrated, cross-sector working is needed to promote health literacy with professionals from health and social care services supported by those from other sectors such as child and adult education services and the third sector. Employers, communities and families also have a role to play in implementing successful health literacy initiatives.