Health literacy as essential cornerstone in co-production of health

Health literacy is closely linked to literacy and entails the knowledge, motivation and competences to access, understand, appraise and apply information to form judgment and take decisions in terms of healthcare, disease prevention and health promotion to maintain and improve quality of life during the life course (Sorensen et al. (2012): Health literacy and public health: a systematic review and integration of definitions and models. BMC public health, 12(1), 80).

As such personal health literacy plays an essential role for patients in successfully using today’s and tomorrow’s healthcare systems. But even more important it will be how able health care systems and health professionals are in dealing with patients with low health literacy and in improving health literacy of all their patients as an important part of treatment. Changes of health care systems are needed for better fitting the needs, demands and competences of their patients, rather than forcing patients to fit the demands of the traditional paternalistic system.

Evidence tells us that an investment in health literate systems and patients is necessary, because almost one in two citizens (47%) have difficulties in managing their health, when it comes to finding, understanding, judging and using health information to make decisions when they are ill, at risk and trying to stay healthy (HLS-EU Consortium, 2013). In a time of austerity health politicians, providers of services, health professionals and patients alike all have an increased responsibility to make the best and the most out of avaialble resources. By increasing health literacy, research has shown patients to have more equal access to health services, to be more compliant co-producers and be better equipped to make informed decision (WHO, 2013). To give an idea of the potential to be realized, a recent study from United States revealed that the money lost in association to limited health literacy could have covered insurance for all un-insured (2006-index).

To support necessary changes and to develop the health care system of the future into a learning system, representatives of patients have to have more say in planning, governance and management of the system. To fulfill these tasks patient representatives need rights and ressources.

Health professionals need to be aware of the patients competencies to start the communication and the treatment, where the patients are – ensuring easy accessible information that is easy to understand, that can be judged and evaluated and eventually applied in the proper and most efficient manner. Aligning communication, aligning expectations – shared decision making is essential to ensure co-production of health.


Kristine Sorensen, Maastricht University, NL
Jürgen Pelikan, Professor emeritus for Sociology at University of Vienna, A
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