A National Position Paper: Health Literacy from a Structural Perspective-A path to equity in health?

Abstract

Background Health literacy (HL) as an enabler of health equity and health promotion. HL is closely linked to other social determinants of health such as age, sex, education, social status and ethnicity. HL responsiveness is the degree to which systems or organizations make it easier for people to navigate, understand, and use information and services. HL can be enhanced through individual support, by targeting the responsiveness of the health professional workforce, or by taking a structural or organizational HL perspective. Methods In Denmark, the HL Network, which is part of Danish Society for Public Health, developed a position paper for approaching HL from a structural level. In 2018-2019 a rapid literature review was conducted followed by three different methodologies: (i) stakeholder meetings, (ii) expert interviews (policy, practice, research) and (iii) thematic meeting focusing on different dimension of the initial recommendation for the position paper, which was published at the National Conference for Public Health. Results In the position paper eight recommendations were developed to improve HL in Denmark from a structural perspective. The recommendations overall aim to prevent low HL and its consequences by targeting health services at the organizational level. The recommendations are: Integrate HL into Danish health policies and strategiesDevelop HL throughout the life courseInclude HL in health education curriculaIntegrate HL at organizational levelsIntegrate HL into partnership and co-creation processesMeasure and monitor HL using local and national dataDevelop, test and evaluate HL interventionsConsider HL in all forms of health communication Conclusions The recommendations can support the integration of a health literate thinking into current national health strategies, including the ongoing efforts to achieve the 17 UN Global SDGs, and thereby contribute to the equitable distribution of health in the Danish population.