Maeve Murray – Health Literacy across the island of Ireland

When people think of health, we usually focus on doctors and hospitals, eating better and exercising more.

But there is something called health literacy that helps us every day to manage good health and wellbeing.

Health literacy can make some of those challenging health tasks and conversations a bit easier.

This is why the World Health Organisation (WHO) promotes health literacy as a way of empowering citizens and societies to actively engage with their own health. Globally, health literacy is recognised as a critical, modifiable risk factor for health (WHO, Shanghei Declaration: 2016).

What is health literacy?

Health literacy represents the personal competencies and organisational structures, resources, and commitment that enable people to access, understand, appraise, and use information and services in ways that promote and maintain good health (Sørensen et al. 2021).

It isn’t just about taking medicines correctly and reading food labels, it is the ability to find, understand and use health information so that the right choices for health can be made.

As well as having environmental level solutions such as clear, easy to read materials, and appropriate communication training for health professionals.

International research has already explored the advocacy, promotion, and evaluation of health literacy.

Countries such as Australia, Austria, Portugal, and Scotland utilise public authorities to support the development and implementation of health literacy strategies and programmes (M-POHL, 2023).

However, future recommendations for best practice should also consider the specific cultural and contextual environment.

This is important for the island of Ireland, known for its mix of rural and urban communities, separate healthcare structures and a shared border.

Health literacy in Ireland

The recent Slaíntecare Healthy Communities Health Literacy Report (2024) underscored barriers to health literacy in Ireland. Limited health literacy is faced by 40% of Irish adults (Sørensen et al., 2015), which can be viewed as a comparative benchmark for all island health literacy trends.

Individuals with limited health literacy are less likely to engage in preventative healthcare choices as they can lack abilities and critical skills to make informed choices about their health. A shared understanding of health literacy, however, can encourage a cross-sector, coordinated approach to promotion, implementation and development.

Lessons from a Decade of Research on the island of Ireland

A review published by Murray, Behan, Smith, and Goss (2025) examined ten years of Irish health research on both sides of the border (2013–2023) and found a:

• Narrow Focus: Research has mostly focused on individual, adult clinical populations limiting an organisational understanding of the complexities of the systems in which individuals operate.
• Geographic Bias: Concentration on urban cities meaning a lack of contextual understanding of health literacy development across the island of Ireland for future targeted interventions to be implemented.
• Limited Term: Cross sectional snapshots of health literacy limit what is fully understood and, therefore, what is most needed for interventions to be impactful.
• Advocacy for Health Literacy: Healthcare professionals, community members, individuals and youth require support through training and/or the support of others to help make a difference.

Looking to the future

Focusing on a sustained research informed approach, can lead to meaningful health literacy development across the island of Ireland. Understood to be a lifelong process (Drummond et al., 2019), health literacy development, with good health behaviours fostered early in life, can track into adulthood.

Therefore, integrating health literacy into existing policies, programmes and practices means empowering individuals and society for generations to come.

Improving health literacy across Ireland is not merely a healthcare concern, but a social imperative that can lead to better health outcomes, more effective utilisation of the healthcare service, and a healthier nation overall.

A co-ordinated approach, involving multi-sector, top-down and bottom-up practices is needed to develop health literacy at an individual, community, organisational and national level.

References

Drummond, F. J., Reidy, M., von Wagner, C., Livingstone, V., Drennan, J., Murphy, M., Fowler, C., Saab, M. M., O’Mahony, M., & Hegarty, J. (2019). Health Literacy Influences Men’s Active and Passive Cancer Information Seeking. HLRP: Health Literacy Research and Practice, 3(3). https://doi.org/10.3928/24748307-20190430-01

M-POHL. (n.d.). Health literacy policies – how can they be developed and implemented? A guide for policy and decision makers. https://m-pohl.net/sites/m-pohl.net/files/2024-03/Guide_health-literacy-policies.pdf

Murray, M., Behan, S., Smith, C., & Goss, H. (2025). Health literacy research on the island of Ireland: A systematic review. In Health Promotion International (Vol. 40, Number 4). Oxford University Press. https://doi.org/10.1093/heapro/daaf138

Murray, M., Smith, C., Behan., & Goss, H (2024) Sláintecare Healthy Communities Health Literacy Report launched 24th September 2024. https://hilocalgov.ie/app/uploads/2024/09/Slaintecare-Health-Literacy-Report-2024.pdf

Sørensen, K., Pelikan, J. M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., Fullam, J., Kondilis, B., Agrafiotis, D., Uiters, E., Falcon, M., Mensing, M., Tchamov, K., Van Den Broucke, S., & Helmut Brand. (2015). Health literacy in Europe: Comparative results of the European health literacy survey (HLS-EU). European Journal of Public Health, 25(6), 1053–1058. https://doi.org/10.1093/eurpub/ckv043

Sørensen, K., Levin-Zamir, D., Duong, T. V., Okan, O., Brasil, V. V., & Nutbeam, D. (2021). Building health literacy system capacity: a framework for health literate systems. Health Promotion International, 36, I13–I23. https://doi.org/10.1093/heapro/daab153

WHO, Shanghei Declaration (2016) Promoting health in the SDGs: report on the 9th Global Conference for Health Promotion, Shanghai, China, 21–24 November 2016. Geneva: World Health Organization; 2017 (WHO/NMH/ PND/17.5; https://apps.who.int/iris/handle/10665/259183, accessed 3 May 2024)