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Changing patterns of health literacy in Europe

This text explores the trend of health literacy over time and across European countries.
European map
© IMPACCT consortium

Understanding the extent and pattern of peoples’ level of health literacy across populations is important, so that we can better devise interventions to address the problem. It also provides a better understanding of the concept of health literacy, for example as a determinant of health.

Read the article written by Sorensen et al (2015) which provides detail of the research that supports the previous video.

The key findings are that:

  • 1 in 2 (47%) of those surveyed had limited (insufficient or problematic) health literacy.
  • The level of limited health literacy differed substantially across countries (29–62%).
  • There is a higher proportion of people with limited health literacy in subgroups within the population. These subgroups include those with financial deprivation, lower social status, lower educational attainment and older age.

This suggests a social determinant and inequality for those with limited health literacy.

This survey, using the European Health Literacy Survey Questionnaire (HLS-EU), was undertaken in 2011 in 8 European countries. This questionnaire has been developed and translated into many more languages and used in many countries since, not just in Europe. Here you can examine an example from Denmark.

Go and investigate

This survey was undertaken in 2011 in 8 European countries. Investigate if the European health literacy survey questionnaire has been undertaken in your country / region since its first use in 2011.

If your country hasn’t used the survey, another questionnaire may have been used, such as the Calgary Charter on Health Literacy Scale. A useful starting point is Boston University’s Health Literacy Tool Shed where you will find many measures of health literacy.

See if one has been developed in your language and then using its title look online for information about its use. If no survey has been undertaken in your country or region then look at neighbouring regions/countries or use Denmark’s example.

Identify 1 similarity and 1 difference in the results of the survey you have identified with the results of the European survey.


Sørensen, K., Pelikan, J. M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., … & Falcon, M. (2015). Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). European journal of public health, 25(6), 1053-1058.

Pleasant, A., Maish, C., O’Leary, C., Carmona, RH. (2018). A theory-based self-report measure of health literacy: The Calgary Charter on Health Literacy scale. Methodological Innovations.

© IMPACCT consortium
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