Four out of ten Belgians “have limited capacities to lead a healthy life, and don’t have the skills to improve their situation,” according to a report by the federal knowledge centre for health care (KCE), in a report on the subject of health literacy.
Health literacy has been defined as a person’s ability “to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve quality of life.” The concept encompasses questions from the ability to evaluate the validity of health-related arguments such as the debate over vaccination of children, to direct interaction with health-care professionals and the patient’s ability to understand and implement the instructions of doctors and other professionals.
A wide-ranging survey was carried out in eight countries of the EU in 2015, which showed that 47% of those studied “had limited (insufficient or problematic) health literacy”. However for individual countries the figures ranged from 29% to 62%. And in any case, Belgium was not one of the countries taking part.
Instead, the survey on which the KCE bases its figures on a study that took place at the end of last year which set out to determine levels of health literacy in Belgium, as well as examining policies for the promotion of health literacy in six countries – Australia, Austria, Ireland, the Netherlands, Portugal and Scotland. Finally, the report examines the value to Belgium of adopting successful policies in use elsewhere.
The full report is available in English, as well as the supplement examining the six foreign countries. The synthesis of the 74-page report is only available in French and Dutch.
The report looked at a study carried out by the Christian health insurance fund or mutuelle, and found that health literacy is “limited” for 29.7% of those studied, and “insufficient” for 11.6% of the 9,616 subjects – a total of 41.3% of people. The figures is within the broad range of results for five of the six foreign countries, but health literacy is “far below the performance of our neighbours in the Netherlands” – where only 36.4% had poor skills.
Belgium shows slight variations in good health literacy according to region. Nationally, 59% have adequate skills; for Flanders the number is 62%, for Brussels 53% and for Wallonia 49%.
“Gender and age affected health literacy skills: the percentage of sufficient literacy was
significantly higher among women (60.9%) than men (56.2%),” the report states. “It was also better in subjects aged 25 to 74 years (approx. 60%) than in young adults in the 18-24 age group (45.5%) and in those over 75 years of age (49.2%).”
Belgium has adopted a wide range of health literacy promotional tools, some federal, community-based or regional, up to and including a promotion plan for 2018-2022 from the French Community Commission in Brussels (Cocof).
The KCE makes a number of recommendations, starting with efforts to bridge the digital gap which leads to lower health literacy among some groups. “But health-care providers also have to develop their communications skills, for example by training.”
Another target for improvement involved mutuelles and care institutions like hospitals. “They have to develop an internal culture that works towards health literacy. The training of all parties is very important. In addition, the appointments system could be made less complex, and the signalisation in hospitals could be reviewed to examine whether information given is sufficiently clear.” The report recommends these professional bodies cooperate more closely with patient associations.
Finally, the KCE recalls the responsibility of governments to design the overall framework in which to make policies that help towards increased health literacy. Since Belgium has to many different levels of official responsibility, the KCE recommends the creation of an inter-ministerial conference on the topic.
“This country already has a great deal of expertise available in the area of health literacy,” the report concludes. Many actors at every level and in all sectors are already aware of the problem. Now it is time to identify the driving forces, to evaluate the existing initiatives and together to consider how all of these efforts can be improved.”