France’s First Participation in a European Survey on Adult Health Literacy

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

This survey provides an initial snapshot of health literacy levels in France. It measures the difficulties adults face 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 conducted in two waves (May 2020 and January 2021) among more than 2,000 adults aged 18 to 75 residing in mainland France. Health literacy levels were classified into four categories: excellent, sufficient, problematic, or inadequate.

4 in 10 French people have an insufficient level of health literacy

The survey results indicate that 30% of respondents have a “problematic” level of health literacy and 14% a level deemed “inadequate.” This means that 44% of adults have difficulty using health information independently.

Three other dimensions of health literacy were explored in the survey and show varying results:

• 73% of adults in France have difficulty navigating the healthcare system (and among them, 49% have significant difficulty)

• 29% have difficulty communicating with healthcare professionals

• 72% have difficulty accessing, understanding, and using online health information (this is referred to as digital health literacy).

This assessment thus helps identify the most frequent or problematic difficulties in order to identify priority areas for improving health literacy in all its dimensions.

Improving health literacy: a national and international challenge

The results obtained are generally similar to those of other countries that participated in this survey. They highlight the importance of health literacy in understanding and reducing social health inequalities through the promotion of more equitable healthcare, education, and health promotion systems1.

These results also highlight the need for alignment between individuals’ competencies and health services’ information systems. Finally, they underscore the need to develop initiatives at all levels: from the local to the international scale. These actions aim to improve populations’ health literacy levels on the one hand, and to better account for populations in all their diversity on the other, with particular attention to those with the lowest levels of health literacy. Further research is needed to guide public policies toward effective or promising interventions.

Santé publique France is working to make health information accessible

“Communicating for All” is a key factor in addressing health inequalities, and Santé publique France has been implementing dedicated initiatives for several years as part of an ongoing dialogue with stakeholders and frontline workers:

• Taking into account all levels of literacy in the development and dissemination of its prevention and health promotion initiatives aimed at the general public;

• Raising awareness and providing support within the Agency and among its partners regarding best practices to make health information accessible;

• Deployment and availability on its website, in the “Information Accessible to All” section, of tools designed for audiences who have difficulty accessing information. Co-developed with target audiences and on-the-ground stakeholders (associations, healthcare professionals, medical-social workers, etc.), these communication materials take into account the needs of all audiences, regardless of their health literacy levels. Some tools address specific needs: documents translated into multiple languages, French Sign Language (LSF) videos, Braille documents, etc. They can be viewed online, downloaded, and ordered (they are then sent free of charge to those who request them).

• Design and distribution of a guide that formalizes recommendations for developing information accessible to all, taking into account the needs of the target audiences. The guide is intended primarily for public and private organizations such as municipalities, healthcare facilities, social and medical-social institutions and services, associations, and businesses, across all sectors. It is designed to support all stakeholders in designing and sharing information accessible to everyone, regardless of their target audiences or their level of health literacy.

Furthermore, Santé publique France supports research teams working on health literacy and contributes to advancing scientific knowledge on health literacy by incorporating this dimension into some of its surveys.