An overview of PLOS curated collection in health literacy (Public Library of Science)

1️⃣ ANALYTICAL SUMMARY

A cross-cutting determinant, but absent from the SDGs

Health literacy — the ability to find, understand, evaluate and use health information — is not explicitly named in the Sustainable Development Goals, yet it underpins SDG-3 and universal health coverage (p.1-2). Individuals with low literacy accumulate less prevention, lower healthcare utilisation, and higher mortality (p.2). Women, refugees, the elderly, and those with low socio-economic status are disproportionately affected (p.2). The PLOS collection, launched in 2024 from articles published between 2022 and 2024, brings together 22 studies covering Europe, North America, Africa, Asia, and Oceania (p.2).

Four axes and a focal point: measurement

The document organises the collection around four axes: literacy as a health determinant, access to care, interventions, and integration into policies (p.2-4). It emphasises measurement through established tools such as the European Health Literacy Survey Questionnaire, while reminding of the need to adapt these tools to cultural contexts (p.3). It documents concrete levers: communication in plain language by healthcare providers (p.4), visual and pictorial aids (p.4), peer educators in schools and community health workers from the communities (p.4). It finally highlights the role of decision-makers in embedding literacy into health policies and systems (p.4-5).

2️⃣ KEY POINTS OF THE DOCUMENT

1️⃣ The collection brings together 22 original studies selected from various PLOS journals (2022-2024), with varied designs (scoping and systematic reviews, randomised trials, quantitative surveys, qualitative interviews) and coverage of all five continents (p.2).

2️⃣ The measurement of literacy is set as a prerequisite: the document cites the European Health Literacy Survey Questionnaire as a reference tool, alerting to its limitations and the need for cultural sensitivity and adaptation to populations (p.3).

3️⃣ Literacy appears closely linked to social determinants (age, education, employment, socio-economic status). The cited studies from Sweden and Switzerland show that refugees and disadvantaged individuals are particularly exposed to low literacy (p.3).

4️⃣ Emergence of the digital health determinants (DDOH) and digital health literacy: accessing, understanding, and using online health information becomes a critical skill, while creating new divides (p.3-4).

5️⃣ The most highlighted interventions are not top-down: simple language communication by caregivers, visual aids, peer education in school settings, and mobilising community health workers from the affected communities (p.4).

3️⃣ ACTION POINTS FOR LOCAL ACTORS

The document is a synthesis, not a practical guide. The points below translate what it indicates in terms of field orientations; operational tools can be found in source articles or French-speaking guides (see section 4).

1️⃣ Adopt the principle of simple communication described p.4: avoid medical jargon, rephrase, actively listen to concerns — the most accessible and immediately actionable lever in consultation or reception.

2️⃣ Mobilise visual and pictorial aids for audiences with low literacy or non-native speakers, of which the document highlights the effectiveness on behaviour change (p.4).

3️⃣ Rely on peers and community agents from the targeted populations (p.4): they bridge the cultural and linguistic gap that external professionals cannot ensure alone.

4️⃣ Prioritise targeting overexposed audiences — migrant, elderly, vulnerable individuals, those with disabilities (including the deaf community, p.3-4) — rather than a one-size-fits-all approach.

5️⃣ Use a validated measurement tool (such as the European Health Literacy Survey Questionnaire, p.3) to objectively assess needs before taking action, ensuring it is culturally adapted to the local audience.

6️⃣ Elevate literacy to the organisational and political level (p.4-5): integrate document readability and information accessibility into structural projects, not just in individual relationships. Unmet need in the document: it does not provide an organisational self-assessment grid or action plan model — to be supplemented by the resources in section 4.

4️⃣ ADDITIONAL REFERENCES

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Health Practices — Collection "Open Notebooks":  Health literacy: from individual competence to organisational responsibility - Prevention, health promotion and access to quality care: understand, act, make accessible - https://www.pratiquesensante.com/litteratie

5️⃣ FREQUENTLY ASKED QUESTIONS (FAQ)

1️⃣ What is health literacy, according to this document?

The ability to access, understand, evaluate and use health information to make informed decisions (p.1-2). The term was coined in the 1970s (p.2).

2️⃣ Why is this topic important if literacy is not in the SDGs?

Because it underpins SDG-3 and universal health coverage: without it, individuals cannot mobilise the available health services (p.1-2).

3️⃣ Who is most affected by low literacy?

Women, refugees, elderly people, those with low socio-economic status, people with disabilities including the deaf community (p.2-4).

4️⃣ How do we measure health literacy?

Through established tools like the European Health Literacy Survey Questionnaire, provided they are culturally adapted to the audience (p.3).

5️⃣ What interventions does the document consider effective?

Simple language from caregivers, visual/pictorial aids, peer education in schools, and community health workers from the communities (p.4).

6️⃣ What is digital health literacy and the DDOH?

The ability to use online health information and tools (p.3-4). The "digital determinants of health" refer to the influence of digital technology on access inequalities (p.3).

7️⃣ What is the role of policymakers?

To fund, raise awareness, promote equity, and integrate literacy into health system policies and strategic documents (p.4-5).

6️⃣ REWRITING IN EASY TO READ LANGUAGE

What « health literacy » means

Health literacy is understanding health information.

It is also knowing how to search for and use this information.

This helps make good decisions about one's health.

The problem

Many people struggle to understand this information.

These people take less care of themselves.

They visit the doctor less often. They get sick more frequently.

It is harder for some people: older people, migrants, poor people, deaf people.

What the document says

Researchers have gathered 22 studies on this topic.

These studies come from all over the world.

They show the same thing: better understanding of information helps to stay healthy.

What works to help

• Caregivers speak in simple words.
• Images and drawings are used.
• Community members help others to understand.
• Needs are assessed before taking action.

What to remember

Understanding one's health is a right.

Those in charge must help everyone to understand.

7️⃣ CROSS-SECTIONAL ANALYSIS — VALUES OF HEALTH PRACTICES

Literacy: the document names measurement tools (European Health Literacy Survey Questionnaire) and the principle of plain language, but does not provide ready-to-use adapted materials (p.3-4).

Empowerment: it values the decision-making autonomy of individuals, without describing a structured approach to involving beneficiaries (p.3-4).

Participation : peer education and community agents are cited as levers, but no formal mechanism for co-construction is detailed (p.4).

Community health : the collective dimension is present through health agents from the communities, without a developed community model (p.4).

Ethics : the cultural limitations of measurement tools are explicitly noted (p.3); biases are not addressed beyond this observation.

Human rights : equity and the reduction of inequalities are a guiding thread, but the approach remains descriptive, not normative (p.4-5).

Intersectorality : the health–education link is highlighted (school, heads of institutions) as a space for action (p.4-5).

Partnership : the collaboration between caregivers–patients and communities is mentioned, without a formalised collaboration model.

Combating discrimination : the document identifies the exclusion of marginalised groups (migrants, deaf individuals) as a factor of low literacy; non-judgment is not explicitly thematised (p.3-4).

8️⃣ EVALUATION OF THE RELIABILITY OF THE RESOURCE

Scientific relevance : strong in terms of credibility — open access article in PLOS One, recent (January 2026), 33 references, academic authors. Important limitation to be aware of: it is a narrative synthesis, not a systematic review — no reproducible selection methodology, which limits the scope of generalisations. Conflict of interest declared by the review (first author on the editorial board). Some associations are presented consensually without nuance on the strength of evidence.

Operational relevance : moderate. Excellent for framing, arguing and directing towards primary studies or priority audiences. Low in practical autonomy: no tool, grid or protocol directly usable. Must be coupled with French-speaking operational resources (section 4) to take action.

9️⃣ STRATEGIC HASHTAGS

#HealthLiteracy #SocialDeterminants #CommunityHealth #HealthInequalities #DigitalLiteracy #HealthCommunication #FALC #healthpractices