The social and economic benefit of health literacy interventions in the WHO EURO region

Abstract

Background Health literacy (HL) allows people to make informed decisions regarding their health, enabling them to understand health promotion activities and to self-manage their disease or complication without requiring support from healthcare services. HL has the potential to support sustainability in health systems by decreasing healthcare spendings stemming from lowered disease occurrence and progression, it can also impact on the rest of peoples’ lives and their surroundings by allowing them to be more independent. This study researched the evidence for return on investment and the social return on investment for health literacy interventions within the WHO EURO region. Methods A narrative literature review on published peer-reviewed reviews and grey literature was conducted by use of keywords and MeSH terms. Google, Google Scholar and PubMed were used find literature. The search on PubMed was restricted to reviews, published within the last 10 years (2009-2019), in English. Results In total, 450 publications were screened 12 publications that analysed the economic or social aspect of HL interventions were identified. Five discussed the cost-effectiveness of health literacy, three the return on investment (ROI) and the remaining three the social return on investment (SROI) of HL. Types of HL interventions ranged from health promotion campaigns, web-based HL programs, prevention systems to education-based interventions. Cost-effectiveness differed between studies and fields. Evidence for ROI was found, the return ratios ranged from 0.62 to 27.4. Findings show SROI between 4.41 and 7.25, indicating additional value of social benefit next to improved health. Conclusions A link between cost-effectiveness and HL interventions was established and ROI and SROI showed positive ratios. Further research is required in order to investigate whether HL interventions consistently achieve a positive returns. Key messages A link between health literacy interventions and positive investment returns has been established. Health literacy interventions show potential for sustainable development of health systems.

Empowering Sustainable Healthcare: The Role of Health Literacy

“…However, according to Schulz and Nakamoto [31] in a brilliant paper describing differences between HL and patient empowerment, this is only the case when a psychologically empowered patient makes risky choices while lacking the adequate knowledge and judgment skills of HL. Conversely, when people possess a solid understanding of their health conditions and the necessary steps for health management, they can contribute to a reduction in generated healthcare costs [32].…”

Building health literacy system capacity: a framework for health literate systems

“…The cost-effectiveness of health literacy and its social and economic return on investment is a growing area of interest based on the added value of interventions, campaigns and programmes. For instance, in a recent health literacy review within the European region of the World Health Organization, the economic return ratios ranged from 0.62 to 27.4 and social return on investments varied between 4.41 and 7.25 ( Stielke et al , 2019 ). It is previously estimated that low health literacy may accommodate for 3–5% of total healthcare costs in the USA ( Eichler et al , 2009 ) because health literacy is inversely associated with healthcare utilization and expenditure.…”

Moving Health Literacy Research and Practice towards a Vision of Equity, Precision and Transparency

“…There is promising evidence showing the effectiveness of health literacy interventions on health outcomes at the individual and community level [ 20 , 48 , 49 , 50 ]. However, there remain substantial gaps.…”