Background: Health literacy concerns the capacities of people to meet the complex demands of health in modern society. In spite of the growing attention for the concept among European health policymakers, researchers and practitioners, information about the status of health literacy in Europe remains scarce. This article presents selected findings from the first European comparative survey on health literacy in populations. Methods: The European health literacy survey (HLS-EU) was conducted in eight countries: Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain (n = 1000 per country, n = 8000 total sample). Data collection was based on Eurobarometer standards and the implementation of the HLS-EU-Q (questionnaire) in computer-assisted or paper-assisted personal interviews. Results: The HLS-EU-Q constructed four levels of health literacy: insufficient, problematic, sufficient and excellent. At least 1 in 10 (12%) respondents showed insufficient health literacy and almost 1 in 2 (47%) had limited (insufficient or problematic) health literacy. However, the distribution of levels differed substantially across countries (29–62%). Subgroups within the population, defined by financial deprivation, low social status, low education or old age, had higher proportions of people with limited health literacy, suggesting the presence of a social gradient which was also confirmed by raw bivariate correlations and a multivariate linear regression model. Discussion: Limited health literacy represents an important challenge for health policies and practices across Europe, but to a different degree for different countries. The social gradient in health literacy must be taken into account when developing public health strategies to improve health equity in Europe.

BackgroundAlthough the increasing dissemination and use of health-related information on the Internet has the potential to empower citizens and patients, several studies have detected disparities in the use of online health information. This is due to several factors. So far, only a few studies have examined the impact of socio-economic status (SES) on health information seeking on the Internet. This study was designed to identify sociodemographic and health-(care-)related differences between users and non-users of health information gleaned from the Internet with the aim of detecting hard-to-reach target groups.MethodsThis study analyzed data from the NRW Health Survey LZG.NRW 2011 (n = 2,000; conducted in North Rhine–Westphalia, Germany, via telephone interviews). Logistic regression analysis was used to examine the determinants of online health information seeking behavior.Results68% of Internet users refer to the Internet for health-related purposes. Of the independent variables tested, SES proved to exert the strongest influence on searching the Internet for health information. The final multivariate regression model shows that people from the middle (OR: 2.2, 95% CI: 1.6–3.2) and upper (OR: 4.0, 95% CI: 2.7–6.2) social classes are more likely to seek health information on the Internet than those from the lower class. Also, women are more likely to look for health information on the Internet than men (OR: 1.5, 95% CI: 1.1–2.1). Individuals with a migration background are less likely to conduct health searches on the Internet (OR: 0.6, 95% CI: 0.4–0.8). Married people or individuals in a stable relationship search the Internet more often for health information than do singles (OR: 1.9, 95% CI: 1.2–2.9). Also, heavy use of health-care services compared to non-use is associated with a higher likelihood of using the Internet for health-related matters (OR: 1.7, 95% CI: 1.2–2.5).ConclusionsIn order to achieve equity in health, health-related Internet use by the socially deprived should be promoted through measures to increase their level of e-health literacy. Furthermore, longitudinal studies are needed in order to gain reliable data/results on determinants of health-related Internet use.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1423-0) contains supplementary material, which is available to authorized users.

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BackgroundGeneral practitioners (GP) in rural areas of Germany are struggling to find successors for their private practices. Telemonitoring at home offers an option to support remaining GPs and specialists in ambulatory care.MethodsWe assessed the knowledge and attitude towards telemedicine in the population of North Rhine-Westphalia (NRW), Germany, in a population-based telephone survey.ResultsOut of 2,006 participants, 734 (36.6%) reported an awareness of telemedical devices. Only 37 participants (1.8%) have experience in using them. The majority of participants were in favour of using them in case of illness (72.2%). However, this approval declined with age. These findings were similar in rural and urban areas. Participants who were in favour of telemedicine (n = 1,480) strongly agreed that they would have to see their doctor less often, and that the doctor would recognize earlier relevant changes in their vital status. Participants who disliked to be monitored by telemedical devices preferred to receive immediate feedback from their physician. Especially, the elderly fear the loss of personal contact with their physician. They need the direct patient-physician communication.ConclusionsThe fear of being left alone with the technique needs to be compensated for today's elderly patients to enhance acceptance of home telemonitoring as support for remaining doctors either in the rural areas or cities.

Mensing. Community stroke knowledge: a new information strategy using a joint project of the public health service and the hairdressers' guild of the Wesel district. Journal of Public Health, Springer Verlag, 2009, 17 (6) Abstract Objectives The public health programme "Healthy Lower Rhine…against Stroke" is aimed at improving the population's knowledge about stroke and thus at reducing the prehospital phase in patients with suspected stroke. First evaluation results indicate that apart from providing information through the mass media, there is an urgent need to further develop the face-to-face communication approach. This has to be achieved by efficient but also effective means, given that financial and personnel resources are scarce. Study design In cooperation with lögd Bielefeld, the Lower Health Authority of the Wesel District (health department) developed a postcard-sized quiz card containing exclusively correct answers on the issue of stroke, risk factors as well as symptom and action knowledge. For face-to-face communication, the hairdressers could be convinced to be included in the project. The hairdressers posed the corresponding questions and marked those answers of the clients that were identical with the quiz card answers with a cross. Answers not given by the clients were read out loud to them by the hairdressers, who were thus "styling up" the knowledge of their clients. To increase participation in the project, prizes were offered for the hairdressers with the most filled-in quiz cards as well as for three of the participating clients (drawing of prizes 1-3). More than 380 hairdressers in the Wesel district were sent a letter inviting them to participate as facilitators in this project, which is probably the first of its kind worldwide. Methods The machine-readable quiz cards were collected and statistically evaluated including data regarding age and gender of the participants. Results were to be presented in the form of a descriptive statistic. Results Thirty-three hairdressers from 12 cities and municipalities of the Wesel district participated in this joint action of the Wesel district Department of Health and the Wesel hairdressers' guild, dealing with the monitoring and imparting of basic knowledge on the issue of stroke. Almost 2,000 clients were interviewed by the participating hairdressers, and knowledge gaps were closed by information read out to them. Discussion This innovative approach of imparting knowledge can be regarded as the model of an effective and economical way of communicating health information to the broader public.