Intended for healthcare professionals


Health literacy: towards system level solutions

BMJ 2015; 350 doi: (Published 24 February 2015) Cite this as: BMJ 2015;350:h1026
  1. Trisha Greenhalgh, professor of primary care health sciences
  1. 1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
  1. trish.greenhalgh{at}

A new World Health Organization toolkit aimed at low and middle income countries could help reduce health inequalities in the rest of the world too

In a new resource aimed at low and middle income countries, the World Health Organization has redefined health literacy as “the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health.”1

Low health literacy is associated with poor engagement with health services, health knowledge, concordance with prescribed medication, self management of illness, markers of disease progression, overall health status, and survival. It is also associated with high rates of hospital admission and use of emergency care.2 3 4 5 6 7

Low health literacy is more common in low income and minority ethnic groups, immigrants, people without full citizenship, those with fewer years of education, and older people; it is especially common in people who fall into several of these risk groups.8 9 10 11 People with low health literacy may feel ashamed and try to conceal it from professional carers and family members.12 Differences in health literacy explain a substantial proportion of inequity in the uptake and use …

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