The German National Action Plan on Health Literacy – empirical base,

development and implementationDominique Vogt, Doris Schaeffer, Ullrich Bauer, Kai Kolpatzik, Klaus Hurrelmann

Health Literacy in Germany

• Late uptake of health literacy debates

• This changed with the HLS-EU…

… benchmarking generates political interest

… poor results sparked academic attention

Health literacy Levels for Countries

Sørensen K, Pelikan JM, Rothlin F, Ganahl K, Slonska Z, Doyle G, FullamJ, Kondilis B, Agrafiotis D, Uiters E, Falcon M, Mensing M, Tchamov K, van den Broucke S, Brand H. Health literacy in Europe: comparativeresults of the European healthliteracy survey (HLS-EU). European journal of public health. 2015;25(6):1053-8.

25,1

21,3

19,5

15,6

19,6

9,9

9,1

46,3

38,7

35,9

39,6

34,1

33,7

32,6

26,9

29,7

34,4

30,9

35,3

38,2

50,8

1,8

10,3

10,2

13,9

11,0

18,2

7,5

0% 20% 40% 60% 80% 100%

Netherlands

Ireland

Poland

Greece

Germany (NRW)

Austria

Spain

excellent sufficient problematic inadequate

Health Literacy Survey Germany (HLS-GER)

Project duration: 2013-2016

Study design: Representative, cross-sectional survey amongGerman population (n=2.000), Respondents aged 15-years+

Data collection: computer-assisted personal interviews (2014)

Health literacy: HLS-EU-Q47

Schaeffer D, Vogt D, Berens E-M, Hurrelmann K. Gesundheitskompetenz der Bevölkerung in Deutschland. Ergebnisbericht 2016 [Available from: http://www.uni-bielefeld.de/gesundhw/ag6/downloads/Ergebnisbericht_HLS-GER.pdf, accessed on: 21 February 2017].

Health literacy in the German population

7,3

9,12,1

7,010,6

6,27,59,1

7,57,1

37,88,510,3

38,4

42,825,3

40,118,8

31,742,239,7

3739,8

30,737,144,342,5

44,6

4155,9

43,853,0

45,944,443,9

45,443,8

51,145,8

40,240,5

9,7

7,216,8

9,017,5

16,35,87,4

10,17,0

15,29,476,8

0% 20% 40% 60% 80% 100%

Total

no chronic cond.chronic cond.

no MBMB

low edu levelmedium edu level

high edu level

femalemale

65 y and above46-64 y30-45 y15-29 y

excellent sufficient problematic inadequate

Project: National Action Plan Health Literacy

Lead: Prof. Dr. Doris Schaeffer, University of Bielefeld (Head)Prof. Dr. Klaus Hurrelmann, Hertie School of Governance (Deputy)Prof. Dr. Ullrich Bauer, University of BielefeldDr. med. Kai Kolpatzik, AOK-Bundesverband

Project office: Dr. Dominique Vogt, Hertie School of Governance (from 2017)Dr. Annett Horn, University of Bielefeld

Funders: Robert Bosch Stiftung (Foundation)AOK-Bundesverband (Statutory Health Insurance)

Patron: Minister of Health Hermann Gröhe

Publication of HLS-GER 2016

Review

Meetings of Expert Committee

Stakeholder Consultation

Meetings of Expert Committee

Public Launch 19 February2018

Process of Developing

English version available:

www.nap-gesundheitskompetenz.de

Schaeffer, D., Hurrelmann, K., Bauer, U. and Kolpatzik, K. (eds.): National Action Plan Health Literacy. Promoting Health Literacy in Germany. Berlin: KomPart 2018

Content of the National Action Plan HealthLiteracy in Germany

• Why do we need a National Action Plan on Health Literacy?

• What is Health Literacy?

• Why does Health Literacy gain in importance?

• How good is Health Literacy in Germany?

• How can Health Literacy be improved?

• What are the underlying principles when improving Health Literacy?

4 5

Facilitating collaborationbetween all

actors Seizing thepotential of

digitalisation

54%More thanhalf of thepopulationin Germany

have limited

health literacy

Embedding

in the Health

System

Enabling participation

Principles of implementation

In Germany, aprooximately every second individual has

limited health literacy. People with limited health literacy

find it difficult to find, understand, appraise and apply

health-related information. Therefore, an expert

committee has developed this national action plan to

strengthen health literacy. The plan focuses on four

areas of action and presents 15 specific

recommendations to improve and strengthen health

literacy in Germany.

Reducingsocial and

healthinequalities

Changingindividuals

and environments

Research

Media

Local

communities

Education

Occupation

and workplaceConsumption

and nutrition

Fostering health

literacy in daily

life

RECOMMENDATIONSWhat has to be done?

PRINCIPLESWhat is important?

Navigating the

Health System

Communication

User-friendly

health

informationParticipation

Care for

chronically ill

Coping

with

chronic

illness

National Action Plan – Strengthening Health Literacy in Germany

PROBLEMWhat is the problem?

Making the health

system more

user-friendly

Health literacy

and chronic

illness

Expanding

health literacy

research

In Brief

Self-

Management

Coping with

activities of

daily life

54 55Nationaler Aktionsplan Gesundheitskompetenz

Fostering health literacy in daily life

1.Enabling the education system to strengthen health l i teracy

early in l i fe

2.Promoting health literacy in the workplace

3.Strengthening health l i teracy in relation to consumption-

and nutrit ion-related decisions

4.Facil itating dealing with health information in the media

5.Empowering communities to strengthen health l i teracy locally

Recommendations1–5

Making the health system more user-friendly

6.Establishing health literacy as a standard on all levels of

the health system

7.Facil itating navigation of the health system, increasing

transparency, reducing administrative hurdles

8.Improving communication between health professionals and

the health system users

9.Making health information more user-friendly

10.Facil itating and strengthening patient participation

Health literacy and chronic illness

11.Integrating health l i teracy into the care of the

chronically i l l

12.Facil itating and supporting adequate coping with

chronic i l lness and their implications

13.Strengthening self-management

14.Fostering health l i teracy in coping with activities

of daily l i fe

Expanding health literacy research

15. Expanding research into health l i teracy

Principles for implementing therecommendations into good practice

1. Reducing social and health inequalities

2. Changing both individual and structural conditions

3.Enabling participation

4.Seizing the potential of digitalisation

5. Facili tating collaboration between actors from all

sectors of society

PrinciplesRecommendations

6–10

Recommendations

11–14

Recommendation

15

National Action Plan Strengthening Health Literacy in Germany

An overview of the recommendations

Plans for implementation (1)

Four expert workshops to discuss the national action plan

Workshop 1

Enabling the

education

system to

strengthen

health literacy

early in life

Workshop 2

Integrating

health literacy

into the care of

the chronically

ill

Workshop 3

Facilitating

dealing with

health

information in

the media

Workshop 4

Making the

health system

more user-

friendly

Policy Paper

2nd International Symposium

HEALTH LITERACY

Research – Practice – Policy

May 2-3, 2019

Bielefeld

Key Note Speaker:

Stephan van den Broucke, Ilona Kickbusch, Diane, Levin-Zamir, Don Nutbeam, Jürgen Pelikan, Kristine Sørensen

Plans for implementation (2)

Thank you for your attention!

Dr. Dominique VogtHertie School of Governance

Berlinvogt@hertie-school.org