Health Literacy: An Introduction

What is Health Literacy?

Health literacy  is linked to literacy and encompasses people’s knowledge, motivation and their ability to access, understand, appraise and apply health information in order to make judgements and take decisions in everyday life concerning health care, disease prevention and health promotion to maintain or improve quality of life during the life course (Sørensen et al., 2012).

What is the prevalence of limited health literacy?

According to a comparative study involving eight European countries, around 47% of the population are estimated to have limited (inadequate or problematic) health literacy.  Limited health literacy is more common in the elderly, in people with low socioeconomic status, lower education, and people in poor health (Sørensen et al., 2015).

The prevalence of limited health literacy in the general adult Maltese population was estimated to be 45.8%.  (Health Literacy Survey: Malta 2014, 2015).  Malta has a mean score of 34.0 on the general Health Literacy Index  (on a scale from 0 to 50) when compared to the European average of 33.8 (Health Literacy Survey: Malta 2014, 2015; Sørensen et al., 2015).

Why is health literacy important?

Health literacy is an important determinant of health and may act as a mediator between the social determinants of health and health inequalities (Marmot et al., 2008; Van den Broucke, 2014).  Health literacy is an important component of prevention at all levels.  It empowers individuals to live healthier lifestyles, to know when to seek medical advice, to accept cancer screening interventions, and to better self-manage chronic conditions (Peerson & Saunders, 2009).  Evidence shows that individuals with low health literacy are more likely to develop chronic diseases and demonstrate poor health behaviours, poor adherence to treatment, increased hospitalizations and readmissions, increased morbidity and increased mortality (Kickbusch et al., 2013).


  • Health Literacy Survey: Malta 2014. (2015).
  • Kickbusch, I., Pelikan, J. M., Apfel, F., & Tsouros, A. D. (Eds.). (2013). Health Literacy The Solid Facts. World Health Organization Regional Office for Europe. Copenhagen. Retrieved from
  • Marmot, M., Friel, S., Bell, R., Houweling, T. A. J., Taylor, S., & Commission on Social Determinants of Health, P. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Lancet, 372(9650), 1661–9.
  • Peerson, A., & Saunders, M. (2009). Health literacy revisited: What do we mean and why does it matter? Health Promotion International, 24(3), 285–296.
  • Sørensen, K., Pelikan, J. M., Rothlin, F., Ganahl, K., Slonska, Z., Doyle, G., … Brand, H. (2015). Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). The European Journal of Public Health, 25(6), 1–6.
  • Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., & Brand, H. (2012). Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health, 12(1), 80.
  • Van den Broucke, S. (2014). Health literacy: a critical concept for public health.  Archives of Public Health, 72(1), 10.

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