International Report on the Methodology, Results, and Recommendations of the European Health Literacy Population Survey 2019-2021 (HLS19) of M-POHL

In Europe, interest has grown in measuring the health literacy (HL) of the adult population in relation to public health, disease prevention, and health promotion to inform health policy in the new millennium, partly building on a longer
radition of measuring HL, but with a focus on patients, in the US. The European Health Literacy Survey (HLS-EU, 2009-2012) confirmed the relevance of HL for people’s health for eight countries in the European Union, and this was replicated in follow up-studies for more European and Asian countries. All of these studies demonstrated that HL is limited in a considerable proportion of the general population, with a social gradient for HL and problematic consequences of limited HL for healthy lifestyles, self-reported health, and the utilization of health care services. Following the recommendations of the WHO’s Health Literacy: The solid facts (2013), WHO/Europe initiated the Action Network on Measuring Population and Organizational Health Literacy (M-POHL), with 28 countries involved, to measure HL regularly, starting with the Health Literacy Survey 2019 (HLS19). This survey was carried out in 17 countries in the WHO European Region (Austria, Belgium, Bulgaria, Czech Republic, Denmark, France, Germany, Hungary, Ireland, Israel, Italy, Norway, Portugal, Russian Federation, Slovakia, Slovenia, and Switzerland). In the HLS19 not only General HL was investigated but also specific HLs, namely Navigational HL, Communicative HL with physicians, Digital HL, and Vaccination HL, using newly developed and validated instruments. Furthermore, HL and health-related quality of life was analyzed as a mediator for health costs.