The ability to read a prescription label, understand a discharge summary, or know when a symptom warrants a doctor's visit — these feel like basic life skills. But for nearly one in four adults across 40 countries studied by Economist Impact, they aren't. And the consequences, a newly published policy brief argues, are devastating: poorer health outcomes, widening inequities, and a staggering US$303 billion in avoidable annual healthcare costs.
The report, From Consensus to Action: Driving Progress on Health Literacy, draws on expert interviews and desk research spanning 15 countries to map a way forward. Its central argument is as much cultural as it is medical: health literacy has for too long been treated as a personal failing rather than a systemic one.
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"It's not only about the health literacy of patients — there is much, much more to it," says Orkan Okan, president of the International Health Literacy Association and head of the WHO Collaborating Center for Health Literacy. The real missed opportunities, adds Shyam Sundar Budhathoki, a senior teaching fellow at Imperial College London, arise when "people have partial understanding and strong motivation, but structural and communication barriers are blocking those actions."
A system problem, not a people problem
The report identifies five interconnected steps towards a more health-literate society, but runs through all of them is a single unifying principle: stop blaming individuals and start redesigning systems.
"What we can do is change the system so that people get information in a language they understand, at a literacy level that they can deal with and using a media that they are actually familiar with," says Donald Nutbeam, professor of public health at the University of Sydney and Chair of the WHO Ad-hoc Advisory Group on Health Literacy. "Those are all system responses, as opposed to focusing on what individuals need to do."
The first of the five steps calls for a whole-of-government and whole-of-society approach — one that spans health, education, employment, and the private sector. Tech and media companies, pharmaceutical firms, pharmacies, and retailers all have roles to play. But the report is careful to note a major hazard lurking in any broad, multi-stakeholder agenda. "My great concern is that health literacy will continue to be seen as everyone's business but nobody's responsibility," warns Prof Nutbeam.
From blueprints to action
Several countries — including Scotland, Germany, Australia, New Zealand, and the United States — already have national health literacy strategies in place. Scotland's Making it Easy and Making it Easier plans, for example, produced measurable gains: greater staff training, clearer patient information, and better self-care support. But the report cautions that publishing a strategy is only the beginning.
"A national action plan is only the beginning," says Diane Levin-Zamir, professor of public health at the University of Haifa and research co-chair at the WHO's M-POHL network. "Unless health literacy is backed by stable structures and permanent budget lines, it risks being a beautiful blueprint that never truly reshapes the system."
Misinformation: The invisible barrier
One of the report's more urgent sections tackles the misinformation crisis. As health information proliferates online and AI tools amplify both accurate and false content, people with lower health literacy face the steepest climb. The World Economic Forum named misinformation and its enabling technology a global threat in 2024, and the WHO has since made it a priority area.
Community pharmacists emerge in the report as an underappreciated frontline defence. "Pharmacies sit in the heart of the community, on the high street," observes Laura Sahm, professor of clinical pharmacy at University College Cork. "A good consultation room should be a safe space where people feel comfortable bringing the rumours, worries and half-truths they've picked up from Dr Google or elsewhere."
Measurement matters
The report also calls for stronger, more consistent data collection. Over 200 health literacy measurement tools currently exist worldwide — a sign of both rich activity and troubling fragmentation. "There won't be a one-size-fits-all measure, ever," says Prof Levin-Zamir, who points to Austria, where low health literacy survey scores acted as a national "wake-up call," ultimately spurring the creation of the Austrian Health Literacy Alliance.
The report's closing message is fundamentally optimistic. "We see health literacy as an asset," says Prof Levin-Zamir. Progress is visible — in schools, workplaces, and increasingly in boardrooms. The tools exist. The consensus is there. What remains, the report argues, is the will to act.
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS
