Health literacy research in Europe: a snapshot.

Sirs, Researchers have previously reported that individuals with low health literacy are more likely to have poor health, are less likely to understand their health problems and treatment management, and are at higher risk of hospitalization. One recent editorial article further highlights the confusion around the problem of health literacy that extends beyond health professionals’ understanding of their patients’ health decision-making and improving health information delivery for better medical care, to lay persons’ understanding of the term ‘health literacy.’ Although the importance of health literacy with respect to health behaviour motivation and health outcomes has generally been well described in medical and social science literature, little is known about research production on health literacy in Europe. We performed a literature search of the PubMed database using related search terms in order to give a snapshot view of European countries’ research production related to health literacy. Table 1 presents the results of our search for the period 1985–2005 (last search completed on July 22, 2005) related to the topic terms of health literacy, readability, health competence, and informed consent. All the years were examined by each general subject search term, the terms in combination with ‘Europe,’ the terms in the ‘title’ of publications, and the terms in combination with the term Europe (‘term’[ti] AND Europe). As shown in Table 1 the search for the general term ‘health literacy’ yielded 10 720 articles; however, only 1563 (14.6%) articles regarding health communication were related to Europe. Searching for ‘health literacy’ in the title, we found 154 articles out of which only 2 (1.3%) were related to Europe, both of which were related to mental health literacy. Of note, only 4680 of 29 548 (15.8%) articles regarding the general topic of informed consent were related to Europe. Overall, research articles in the areas of interest published in countries related to Europe were under 25% of the global research production (range 1.3–21.4%). Our brief bibliometric analysis—though it cannot quantify all the papers originating in Europe— confirms that health literacy, readability, health competence, and informed consent constitute research areas that are considerably neglected in the European Union.