Health literacy continues to decline

The results show a sharp decline in health literacy—down more than 20% since 2014. The drop is particularly noticeable among younger people. Interestingly, factors like education, income, or immigration history do not appear to influence the results. 

The study, conducted by TUM in partnership with the WHO Collaborating Centre for Health Literacy and health magazine Apotheken Umschau, found that around 75% of adults now face serious challenges navigating health information. Respondents reported difficulty locating, accurately understanding, critically assessing, and effectively applying information about topics like treating and preventing diseases. 

The figures speak for themselves: in 2014, 54.3% of adults were found to have low health literacy. That rose to 64.2% by 2020, and by 2024 it had jumped another 12 percentage points to 75.8%. That means a growing number of people are struggling not only to make informed decisions about their own health—or their children’s—but also to navigate the healthcare system and access available services. 

Prof. Orkan Okan

Image source: TUM; photo: Andreas Heddergott

The nationally representative survey, which included 2,000 adults and was conducted between July and August 2024, also revealed that health literacy varies by age and region. Older adults - those over 60 - generally scored higher than younger age groups. People living in eastern Germany also tended to perform better than those in the western part of the country. Contrary to past study results, the study found no significant differences based on education level, migration history, income, or gender. 

Orkan Okan, Professor of Health Literacy at the TUM School of Medicine and Health and head of the WHO Collaborating Centre for Health Literacy, added: “We need to put real resources behind health literacy—especially in schools and other learning environments. That’s where lifelong healthy habits begin, and where we can make the biggest long-term difference." 

"The current study is a wake-up call: at a time when automated chatbots work with targeted misinformation and fake news has become socially acceptable, reliable information and infrastructure are needed to navigate the infodemic," emphasizes Prof. Kai Kolpatzik, Chief Scientific Officer at Wort & Bild Verlag (including Apotheken Umschau). "Now is the time to implement the right policies for all people, their health and their quality of life. Our ten demands to politicians are aimed at taking action now on the basis of sound data." 

Claudia Küng, Managing Director of Health Care Bayern e.V.: "Health literacy not only means getting the right help in the event of illness or care, but also knowing when you are really ill - and when you are not. Our healthcare system must offer clear and structured pathways, but also support people in developing confidence in their own abilities. Health and illness are not an either/or, but a continuum - and this awareness must be strengthened. Health Care Bayern e.V. is committed to doing just that." 

Poor health literacy has far-reaching consequences. People with low health literacy are ill more often and for longer, use emergency services more frequently, are hospitalized more often and are less likely to follow treatment recommendations. This places an additional burden on the healthcare system and causes avoidable costs. According to WHO estimates, the resulting costs of a lack of health literacy amount to three to five percent of total healthcare expenditure, which means up to 24 billion euros in Germany in 2022. Improved health literacy would not only improve the quality of life of those affected, but also increase the efficiency of the healthcare system. The basis for this is simple, understandable and reliable health information. 

To support lasting change, study authors Prof. Okan and Prof. Kolpatzik have proposed a ten-point plan, backed by a broad coalition of more than 30 organizations from healthcare, education, and social sectors: 

1. Integrate health education early—starting in kindergarten and school 
2. Strengthen media literacy among children and adolescents 
3. Restrict advertising of unhealthy food to children, including influencer marketing 
4. Train healthcare professionals in modern, effective communication 
5. Promote digital health literacy so everyone can access digital health tools like electronic patient records 
6. Create easy-to-use systems and low-barrier communication to help people navigate healthcare 
7. Expand organizational health literacy within clinics and hospitals 
8. Promote health literacy in the workplace 
9. Strengthen mental health literacy through public campaigns 
10. Apply a “Health Literacy in All Policies” approach across government sectors 

Source: Technical University of Munich 

03.04.2025

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