Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU).

BACKGROUND: Health literacy concerns the capacities of people to meet the complex demands of health in modern society. In spite of the growing attention for the concept among European health policymakers, researchers and practitioners, information about the status of health literacy in Europe remains scarce. This article presents selected findings from the first European comparative survey on health literacy in populations. M ETHODS: The European health literacy survey (HLS-EU) was conducted in eight countries: Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain (n = 1000 per country, n = 8000 total sample). Data collection was based on Eurobarometer standards and the implementation of the HLS-EU-Q (questionnaire) in computer-assisted or paper-assisted personal interviews. R ESULTS: The HLS-EU-Q constructed four levels of health literacy: insufficient, problematic, sufficient and excellent. At least 1 in 10 (12%) respondents showed insufficient health literacy and almost 1 in 2 (47%) had limited (insufficient or problematic) health literacy. However, the distribution of levels differed substantially across countries (29-62%). Subgroups within the population, defined by financial deprivation, low social status, low education or old age, had higher proportions of people with limited health literacy, suggesting the presence of a social gradient which was also confirmed by raw bivariate correlations and a multivariate linear regression model. DISCUSSION: Limited health literacy represents an important challenge for health policies and practices across Europe, but to a different degree for different countries. The social gradient in health literacy must be taken into account when developing public health strategies to improve health equity in Europe.

Survey of the curricula of public health training programs across Bulgaria and Greece: opportunities for future collaboration.

Increased communication between neighboring countries may bring to the foreground the common health hazards of the populations but it also creates opportunities for joint actions, especially in the field of public health where knowledge and expertise are critical factors for effective collaboration. In this light, a questionnaire based survey on the curricula of public health training programs in Bulgaria and Greece was conducted in order to investigate any similarities and discrepancies. The survey focused on the various characteristics of the institutions that provide training in public health, e.g., the structure and duration of each course and the evaluation procedures. The results showed that the principal subjects such as public health, epidemiology, biostatistics and health promotion are present both in the Greek and Bulgarian curricula. Similarities are observed in other subjects as well, but differences exist as to whether these subjects are core or elective. The Greek curricula are more flexible (greater number of elective subjects) whereas Bulgarian curricula are structured around a wider core. Differences were observed in the duration of the programs, the teaching methodology and the issues of evaluation/accreditation. Collected data can serve as a basis for establishing a fruitful dialogue and contribute to the achievement of consensus in public health policy planning and actions for both neighbouring countries.