Healthcare Improving health literacy

Health literacy involves a range of skills that are important when dealing with health information. This not only includes people’s own knowledge, but also the motivation and ability to deal with information about health. In other words, health literacy also includes the way in which people find, assess and use health information. 

Nowadays, finding information about health is easy. Between printed formats and websites, it is available everywhere and at all times. However, assessing the credibility and quality of health information can be difficult, especially in the case of internet-based sources. As such, personal information from experts is as important as ever. This can be obtained from advice centers or self-help organizations as well as through consultations with doctors or other treatment and care specialists.

A good level of health literacy is essential to being able to find and understand reliable information. It also helps people to apply the knowledge they acquire to their daily lives and helps them to get the most out of a visit to the doctor, either for themselves or a loved one. 

People also need sufficient health literacy to use institutions and structures within the healthcare system to promote their own health.

People’s health literacy needs change depending on their circumstances – for example, moving to a new country or being newly diagnosed with an illness. 

What is digital health literacy?

Being digitally health literate means being able to use health-related digital information and information opportunities. Examples of digital healthcare services include video consultations, the electronic patient record (ePA) and digital health applications (DiGA), also known as apps on prescription.

In addition to digital health literacy, there are also several other factors that influence the ability to use digital services. One basic prerequisite is that devices such as smartphones and computers are available and that people have the necessary skills to use them. Accessibility is also key to everyone being able to use the digital services.

If you are well informed about your health and can apply your knowledge to everyday life, you can play an active role in your own healthcare. For example, if you know why oral hygiene is so important, you will brush your teeth regularly and are likely to have fewer cavities. The same applies to dealing with other illnesses: If people understand the reasoning behind a treatment for a chronic disease, they may be more willing to follow the course of treatment consistently. This means that health literacy can help to promote people’s own health and therefore also contribute to a better quality of life.

It is also known that a low level of health literacy is often associated with an unhealthy lifestyle – for example, with not eating a healthy diet and not getting enough exercise. In addition, people with poor health literacy feel less healthy, tend to be more overweight, are absent from work more frequently due to illness and are more likely to need to use the services of family doctors, hospitals and emergency services.

People who are well informed can play an active role in decisions affecting their health. These days, treatment plans tend to be decided upon by doctors and patients in consultation, rather than by medical professionals alone. A good level of health literacy facilitates joint decision-making.

Health literacy can help people develop and maintain a healthy lifestyle. For example, it plays an important role in people doing a healthy amount of sport and exercise: in addition to basic physical abilities, this also requires knowledge about the body and exercise. Setting and achieving goals also depends on personal motivation. People must also be able to choose types of exercise that are in line with their own preferences and abilities.

What other factors can influence people’s behavior with regard to health?

Several other aspects are also important when it comes to health-conscious behavior. For example, to make use of health services at all, people need to be familiar with their local healthcare system. Information about how the healthcare system is organized, navigation tools and structural changes can make it easier to grasp the healthcare system.

Behavior is also particularly shaped by external factors, such as:

• income, educational and profession
• personal environment
• social etiquette (standards)

Knowledge about healthy and unhealthy behavior alone is often not enough for people to change their lifestyle. For example, drinking alcohol is normal in large parts of society. However, most people know that alcohol is harmful to our health. Despite this, the social acceptance of alcohol is so far-reaching that people are sometimes surprised or uncomprehending when it is declined. The result is that some people adapt to the behavior of those around them because they want to belong or don’t want to have to justify themselves. This is why advocating health-conscious behavior is something that must be done by society as a whole.

A huge volume of digital health information is available and is used by many people – around 70 percent of people use online sources when they have questions about health. However, it’s not always easy to tell whether information on the internet is of a high quality. Which is why, in one survey, over two-thirds of people interviewed said that they would consult a doctor first if they had any urgent questions about health. Only around one-fifth of respondents said that they would look for the answer online first.

Digital services such as video consultations can be of particular interest to people with poor health. They are primarily used by educated people aged between 30 and 50 with a high level of digital health literacy and a higher professional or financial status.

How health literate are people in Germany?

A survey on health literacy in Germany has shown that over half of the population struggles to deal with health information.

People with a low level of education or low social status as well as those who are more elderly or financially disadvantaged have a particularly low level of digital health literacy. At the same time, many elderly people have a low level of trust in internet search engines. As a result, they rarely use digital services.

On the other hand, people from a migrant background have a better level of health literacy and make greater use of digital services than the general population.

Furthermore, 8 out of 10 people find it hard to get a clear grasp of the healthcare system. For example, they struggle to find out their rights as a patient.

The gesund.bund.de health portal was created to make it easier for all citizens to access reliable health information online. The website of the Federal Institute for Public Health (Bundesinstitut für Öffentliche Gesundheit) offers quality-assured information and recommendations on health.

In Germany, around 3 out of 4 people have major difficulties assessing digital health information and struggle to determine whether websites are trustworthy and unbiased. It is therefore useful to know how to identify high-quality information.

The German Network of Evidence-Based Medicine (Deutsche Netzwerk Evidenzbasierte Medizin e.V.) sets out criteria for reliable health information in its position paper on good practice in health information.

In addition, health information must always be based on scientific evidence. Such evidence could show the effectiveness and safety of a treatment method, for example.

The content of health information should not only be fully accurate but also prepared in a way that users can understand.

The authors and publishers of health information must present themselves transparently and disclose their motives, objectives and financing. This information should be included in a website’s “Legal Notice”. Other relevant information can normally be found on its “About us” page. This page should also specify how frequently the information is updated. As a general rule, reliable health information should also be advertising free.

Alongside the gesund.bund.de health portal and the website of the Federal Institute for Public Health, there are many organizations that provide high-quality online health information that is easily understood and presented in an interesting way.

The German Health Competence Network (“Deutsche Netzwerk Gesundheitskompetenz e.V.”) provides an overview of providers of health information that meet certain quality criteria.

For specific medical questions, decision-making tools can help people make decisions on treatment methods. The Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen – IQWiG) provides decision-making tools in relation to numerous medical questions on its website gesundheitsinformation.de.

Both statutory and private insurance funds also offer their policyholders a wide range of information and advice on health and digital health literacy matters, for example step-by-step instructions on how to install and use the electronic patient record.