Health literacy: what difficulties do the French face?

France participates for the first time in a European survey on adult health literacy

France has participated for the first time alongside 16 other countries in the Health literacy survey 2019-2021. It is the result of an international collaboration initiated by the Action Network on Measuring Population and Organizational Health Literacy (M-POHL), under the aegis of the WHO's European Health Information Initiative.

This survey provides the first French snapshot of health literacy levels, i.e. the skills needed to locate, understand, evaluate and use information enabling an individual to maintain and improve his or her health. The survey measures the difficulties encountered by adults in accessing, understanding, evaluating and using information to make decisions about their health. It explores several dimensions: health literacy, navigating the healthcare system, communicating with doctors, and digital health tools.

The survey was carried out in 2 waves (May 2020 and January 2021) among more than 2,000 adults aged 18 to 75 living in mainland France. Health literacy levels were classified into four levels: excellent, sufficient, problematic, or inadequate.

4 out of 10 French people have an inadequate level of health literacy

The survey results show that 30% of those questioned have a "problematic" level of health literacy, and 14% an "inadequate" level. This means that 44% of adults have difficulty using health information independently.

Three other dimensions of health literacy were explored in the survey, with varying results:

• 73% of adults in France have difficulty navigating the healthcare system (and of these, 49.2% have great difficulty)
• 29% have difficulty communicating with healthcare professionals
• 72% have difficulty accessing, understanding and using online health information (known as digital health literacy).

It has been shown that obstacles are more frequent among people with lower social status or chronic health problems. 

This review will help identify the most frequent or most problematic difficulties, to identify priority avenues for improving health literacy in all its dimensions.

Improving health literacy: a national and international challenge

The results obtained are broadly similar to those of the other countries that took part in this survey. They demonstrate the value of health literacy in understanding and reducing social inequalities in health, through the promotion of more equitable health care, education, and promotion systems.

These results also highlight the need to match people's skills with the information systems of health services. Finally, they reinforce the need to develop actions at all levels: from the most local to the international. These actions aim to improve the health literacy levels of populations on the one hand, and to take better account of populations in all their diversity on the other, with particular attention to those with the lowest levels of health literacy. Acting on the level of health literacy is therefore a potential lever for reducing social inequalities in health, as access to health rights and services (care, prevention, and health promotion) is conditioned by access to easily appropriable information. Further work is needed to guide public policies towards effective or promising actions.