Health Literacy as a Global Public Health Concern: A Systematic Review

Abstract

Low health literacy is known to be a 'silent killer'. This can be tackled by closing the gaps between health messages and health messengers by using simplified language and including cultural appropriateness. The aim of this review paper was to systematically analyze the concept of health literacy, its measurement tools and related barriers along with interventions used to improve health literacy in developed and developing countries including Pakistan. A total of 54 studies were retrieved from databases related to health literacy among which 33 studies were from developed countries, 16 from developing countries, and 5 studies from Pakistan. The review paper concludes that the multiple dimensions of health literacy are still yet to be clearly explained. Most of the studies used either REALM or TOFHLA for measurement of health literacy, which are not sufficient for measuring health literacy beyond the ability to read and understand medical information.Although, health literacy in most of the developed countries is adequate but it is still questionable in developing countries including Pakistan. Limited studies have examined impact of different interventions for improving health literacy especially in specific populations. Extensive research is required to explore economic implications of limited health literacy on the health system and the cost-effectiveness of interventions to improve health literacy. Furthermore, effectiveness of media literacy education addressing health and language barrier to comprehend medical instructions, prescriptions and drug labels should be investigated.

Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population

“…A systematic review of 19 articles showed that urban populations have higher HL than rural populations [48]. Another systematic review of 54 studies that compared the HL of populations between developed and developing countries concluded that those in developed countries have higher HL than in developing countries [49]. Thus, disparities in findings between various studies could also be explained based on the systematic national health policy spearheaded by the government in developed countries [50].…”

Trends of global health literacy research (1995–2020): Analysis of mapping knowledge domains based on citation data mining

“…Studies have shown that low-income populations primarily have low reading skills, leading to their low health literacy [ 4 , 5 ], especially in countries that are densely populated and ethnically and culturally diversified but heavily engaged in human development, economic stability and primary health care. At the same time, these countries are faced with great challenges in terms of providing health services to disadvantaged groups with low literacy rates and low socioeconomic status [ 6 ]. Thus, improving health literacy is an urgent need to facilitate and achieve the health-related United Nations Millennium Development Goals.…”

Health Literacy and Health Behavior Among Women in Ghazni, Afghanistan

“…Besides differences in levels of health literacy between countries, research shows that a substantial proportion of people have difficulties dealing with health information even within each country worldwide (19). The European Health Literacy Survey indicated 30-63% of the population have limited health literacy, depending on the European country considered (7).…”