Journals / Arel Üniversitesi Sağlık Bilimleri Dergisi / 2026 / Cilt: 10 Sayı: 1

Evaluation of Health Literacy by Countries and Its Implications for Public Health

Sağlık Okuryazarlığının Ülkeler Bazında Değerlendirilmesi ve Toplum Sağlığı Açısından Yönü

Manzura Yylmaz(ÜSKÜDAR ÜNİVERSİTESİ)0009-0003-9316-4679
Pages
10–21
Publication Date
2026-04-30
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Low health literacy adversely affects critical health behaviors such as early diagnosis, treatment adherence, access to healthcare services, and overall public health outcomes, leading to increased costs in the healthcare system.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Health literacy is a key indicator for individuals to effectively benefit from health services and for the development of public health.
📊
Key Findings & Data:Studies such as the HLS-EU in Europe reveal significant differences between countries; the Netherlands stands out with the highest literacy rate, while Bulgaria ranks lowest.
💡
Conclusion & Impact:Low health literacy adversely affects critical health behaviors such as early diagnosis, treatment adherence, access to healthcare services, and overall public health outcomes, leading to increased costs in the healthcare system.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Küresel Karşılaştırma · Sağlık Okuryazarlığı · sağlık politikaları

Abstract

Health literacy is a key indicator for individuals to effectively benefit from health services and for the development of public health. This review evaluates the levels of health literacy in different countries across continents and discusses their impact on public health. Studies such as the HLS-EU in Europe reveal significant differences between countries; the Netherlands stands out with the highest literacy rate, while Bulgaria ranks lowest. In the United States, more than one-third of adults have inadequate or problematic levels of health literacy. Although 91% of Australians state that they can manage their health, 59% of the population lacks sufficient basic health literacy skills. In Asia, assessments of health literacy are limited, and countries like Indonesia and Vietnam show lower literacy levels. In Turkey, both inadequate and problematic health literacy rates are above the European average. Low health literacy adversely affects critical health behaviors such as early diagnosis, treatment adherence, access to healthcare services, and overall public health outcomes, leading to increased costs in the healthcare system. Therefore, developing policy and education strategies to improve health literacy is of great importance.

Özet

Sağlık okuryazarlığı bireylerin sağlık hizmetlerinden etkili şekilde yararlanabilmesi ve toplum sağlığının gelişmesi açısından temel bir göstergedir. Bu derleme çalışmasında, farklı kıtalardaki ülkelerde sağlık okuryazarlığı düzeyleri değerlendirilmiş ve bu düzeylerin toplum sağlığına olan etkileri tartışılmıştır. Avrupa’da yapılan HLS-EU araştırmaları, ülkeler arasında belirgin farklılıklar olduğunu ortaya koymuş, özellikle Hollanda’nın yüksek, Bulgaristan’ın ise düşük okuryazarlık düzeyine sahip olduğunu göstermiştir. ABD’de yetişkinlerin üçte birinden fazlası yetersiz ya da sorunlu sağlık okuryazarlığı düzeyindedir. Avustralya’da halkın %91’i sağlıklarını yönetebileceğini belirtse de %59’u yeterli düzeyde temel sağlık okuryazarlığına sahip değildir. Asya’da ise sağlık okuryazarlığı değerlendirmeleri sınırlı kalmakta; özellikle Endonezya ve Vietnam gibi ülkelerde yetersiz düzeyler gözlenmektedir. Türkiye’de ise yetersiz ve sorunlu sağlık okuryazarlığı oranı Avrupa ortalamasının üzerindedir. Düşük sağlık okuryazarlığı; erken teşhis, tedaviye uyum, sağlık hizmetine erişim ve toplum sağlığı üzerinde olumsuz etkiler doğurmakta, sağlık sisteminde maliyetleri artırmaktadır. Bu nedenle, sağlık okuryazarlığını geliştirmeye yönelik politika ve eğitim stratejilerinin önemi büyüktür.

🔖

Cite This Article

Yylmaz, M., Yıldırım, A. D. (2026). Evaluation of Health Literacy by Countries and Its Implications for Public Health. Arel Üniversitesi Sağlık Bilimleri Dergisi, Cilt: 10 Sayı: 1, 10–21. https://ajindex.com/articles/1626350

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (40)

  1. Abay, H., Alagoz, F., Tekin, O. M. (2023). The Turkish validity and reliability of the maternal health literacy inventory in pregnancy. Midwifery, 125, 103774. https://doi.org/10.1016/j.midw.2023.103774
  2. Baltacı, N., Kaya, N., Kılıçkaya, İ. (2023). Gebelerin e-sağlık okuryazarlığının ve sağlıklı yaşam davranışlarının incelenmesi. Sürekli Tıp Eğitimi Dergisi, 32(4), 301–313. https://doi.org/10.17942/sted.1229364
  3. Çelik, N. M., Kuçlu, T. (2022). Türkiye’de sağlık okuryazarlığı üzerine yazılan tıpta uzmanlık tezlerinin bibliyometrik analizi. Türkiye Sağlık Okuryazarlığı Dergisi, 3(2), 38–95. https://doi.org/10.54247/soyd.2022.47
  4. Alp, F., Mete, M. (2023). Türkiye’de sağlık okuryazarlığı alanında yürütülen tezlerin bibliyometrik analizi (2011–2022). Sağlık Profesyonelleri Araştırma Dergisi, 5(3), 178–188. https://doi.org/10.57224/jhpr.1231645
  5. T.C. Sağlık Bakanlığı Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. (2018). Türkiye Nüfus ve Sağlık Araştırması 2018: Ana rapor. https://fs.hacettepe.edu.tr/hips/dosyalar/Ara%C5%9Ft%C4%B1rmalar%20-%20raporlar/2018%20TNSA/TNSA2018_ana_Rapor_compressed.pdf
  6. Tandoğan, Ö., Çetinçay, D. D., Yuvarlan, E., Kaydırak, M. M. (2023). Gebelerin sağlık hizmeti alma durumları ve ilişkili faktörlerin belirlenmesi. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, 6(1), 92–100. https://doi.org/10.38108/ouhcd.1086377
  7. 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., Brand, H. (2015). Health literacy in Europe: Comparative results of the European health literacy survey (HLS-EU). The European Journal of Public Health, 25(6), 1053–1058. https://doi.org/10.1093/eurpub/ckv043
  8. Nawabi, F., Krebs, F., Vennedey, V., Shukri, A., Lorenz, L., Stock, S. (2021). Health literacy in pregnant women: a systematic review. International Journal of Environmental Research and Public Health, 18(7), 3847. https://doi.org/10.3390/ijerph18073847
  9. Akran, S. K. (2021). Sağlık okuryazarlığı üzerine sistematik derleme. Uluslararası Beşerî Bilimler ve Eğitim Dergisi, 7(15), 143–168. https://dergipark.org.tr/tr/download/article-file/1685005
  10. Duong, T. V., Aringazina, A., Baisunova, G., Nurjanah, N., Pham, T. V., Pham, K. M., Truong, T. Q., Nguyen, K. T., Win Myint Oo, E., Mohamad, E., Su, T. T., Huang, H.-L., Sørensen, K., Pelikan, J. M., van den Broucke, S. (2017). Measuring health literacy in Asia: validation of the HLS-EU-Q47 survey tool in six Asian countries. Journal of Epidemiology, 27(2), 80–86. https://doi.org/10.1016/j.je.2016.09.005
  11. Johnson, A. (2014). Health literacy: Does it make a difference? Australian Journal of Advanced Nursing, 31(3), 39–45. https://doi.org/10.37464/2016.334.1596
  12. World Health Organization. (2024, August 5). Health literacy. https://www.who.int/news-room/fact-sheets/detail/health-literacy
  13. Rajah, R., Hassali, M. A., Murugiah, M. K. (2019). A systematic review of the prevalence of limited health literacy in Southeast Asian countries. Public Health, 167, 8–15. https://doi.org/10.1016/j.puhe.2018.09.028
  14. Nawabi, F., Krebs, F., Lorenz, L., Shukri, A., Alayli, A., Stock, S. (2022). Health literacy among pregnant women in a lifestyle intervention trial. International Journal of Environmental Research and Public Health, 19(10), 5808. https://doi.org/10.3390/ijerph19105808
  15. UNESCO. (n.d.). What you need to know about literacy. https://www.unesco.org/en/literacy/need-know
  16. Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., Brand, H. (2012). Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health, 12, 80. https://doi.org/10.1186/1471-2458-12-80
  17. Taylor, K., Compton, S., Kolenic, G. E., Scott, J., Becker, N., Dalton, V. K. (2021). Financial hardship among pregnant and postpartum women in the United States, 2013 to 2018. JAMA Network Open, 4(10), e2132103. https://doi.org/10.1001/jamanetworkopen.2021.32103
  18. Yee, L. M., Silver, R., Haas, D. M., Parry, S., Mercer, B. M., Wing, D. A., Grobman, W. A. (2021). Association of health literacy among nulliparous individuals and maternal and neonatal outcomes. JAMA Network Open, 4(9), e2122576. https://doi.org/10.1001/jamanetworkopen.2021.22576
  19. American College of Obstetricians and Gynecologists. (2020). Physical activity and exercise during pregnancy and the postpartum period (Committee Opinion No. 804). Obstetrics Gynecology, 135(4), e178–e188. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period
  20. Lori, J. R., Kukula, V. A., Liu, L., Apetorgbor, V. E., Ghosh, B., Awini, E., Dzomeku, V. M., Adanu, R. (2024). Improving health literacy through group antenatal care: Results from a cluster randomized controlled trial in Ghana. BMC Pregnancy and Childbirth, 24, 37. https://doi.org/10.1186/s12884-023-06224-x
  21. Zakar, R., Iqbal, S. (2024). Editorial: Social determinants of women’s health in low and middle income countries. Frontiers in Global Women’s Health, 5, 1482047. https://doi.org/10.3389/fgwh.2024.1482047
  22. Australian Bureau of Statistics. (2018). National health survey: Health literacy. https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-health-literacy/latest-release
  23. Choudhry, F. R., Ming, L. C., Munawar, K., Zaidi, S. T. R., Patel, R. P., Khan, T. M., Goh, K. W. (2019). Health literacy studies conducted in Australia: A scoping review. International Journal of Environmental Research and Public Health, 16(7), 1112. https://doi.org/10.3390/ijerph16071112
  24. Nakayama, K., Yonekura, Y., Danya, H., Hagiwara, K. (2022). Associations between health literacy and information-evaluation and decision-making skills in Japanese adults. BMC Public Health, 22, 1473. https://doi.org/10.1186/s12889-022-13892-5
  25. Sabetghadam, S., Keramat, A., Goli, S., Malary, M., Rezaie Chamani, S. (2023). Maternal health literacy, health information-seeking behavior and pregnancy outcomes among Iranian pregnant women: A cross-sectional study. Community Health Equity Research Policy, 44(1), 77–87. https://doi.org/10.1177/0272684x221095659
  26. Timsin, N., Wangpitipanit, S. (2025). The effects of a health literacy promotion program for prevention of preterm birth among pregnant women who received antenatal care services in the hospital-based. Women and Children Nursing, 3(1), 20–26. https://doi.org/10.1016/j.wcn.2025.01.003
  27. Xu, J., Chen, Y., Zhao, J., Wang, J., Chen, J., Pan, X., Zhang, W., Zheng, J., Zou, Z., Chen, X., Zhang, Y. (2024). Current status of electronic health literacy among pregnant women with gestational diabetes mellitus and their perceptions of online health information: A mixed-methods study. BMC Pregnancy and Childbirth, 24, 392. https://doi.org/10.1186/s12884-024-06594-w
  28. Durusu Tanrıöver, M., Yıldırım, H. H., Demiray Ready, F. N., Çakır, B., Akalın, H. E. (2014). Türkiye sağlık okuryazarlığı araştırması (1. baskı). Sağlık-Sen Yayınları. https://www.sagliksen.org.tr/cdn/uploads/gallery/pdf/8dcec50aa18c21cdaf86a2b33001a409.pdf
  29. Rooney, M. K., Santiago, G., Perni, S., Horowitz, D. P., McCall, A. R., Einstein, A. J., Jagsi, R. (2021). Readability of patient education materials from high-impact medical journals: A 20-year analysis. Journal of Patient Experience, 8, 2374373521998847. https://doi.org/10.1177/2374373521998847
  30. Ghotbizadeh, F., Panahi, Z., Tarafdari Manshadi, A., Soltani, S., Akbari, R., Parsapur, M. (2022). Maternal health literacy and pregnancy outcomes: Does any association exist? Journal of Obstetrics, Gynecology and Cancer Research, 8(1), 68–75. https://doi.org/10.30699/jogcr.8.1.68
  31. Tavananezhad, N., Bolbanabad, A. M., Ghelichkhani, F., Effati-Daryani, F., Mirghafourvand, M. (2022). The relationship between health literacy and empowerment in pregnant women: A cross-sectional study. BMC Pregnancy and Childbirth, 22, 351. https://doi.org/10.1186/s12884-022-04686-z
  32. Kara, P. (2025). Determinants of well-being in pregnancy: The impact of sociodemographic and obstetric variables and maternal health literacy, cross-sectional study. BMC Pregnancy and Childbirth, 25, 524. https://doi.org/10.1186/s12884-025-07654-5
  33. Gözlü, K. (2020). Sağlığın sosyal bir belirleyicisi: Sağlık okuryazarlığı. Medical Journal of Süleyman Demirel University, 27(1), 137–144. https://doi.org/10.17343/sdutfd.569301
  34. Soykan, H., Şengül, H. (2021). Sağlık okuryazarlığının sağlıklı yaşam biçimi davranışlarıyla ilişkisi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 10(4), 691–704. https://doi.org/10.37989/gumussagbil.905512
  35. Değerli, H., Tüfekçi, N. (2018). Toplumun sağlık okuryazarlık düzeyinin belirlenmesi. Avrasya Uluslararası Araştırmalar Dergisi, 6(15), 467–488. https://doi.org/10.33692/avrasyad.510093
  36. Çalık, K. Y., Daştan Yılmaz, A., Günal, N. T., Yıldırım, R. B. (2023). Dünya Sağlık Örgütünün pozitif bir gebelik deneyimi için antenatal bakıma yönelik önerileri. Ankara Sağlık Bilimleri Dergisi, 12(1), 99–113. https://doi.org/10.46971/ausbid.1188344
  37. UNESCO Türkiye Millî Komisyonu. (2023, September 8). Message of UNESCO Director-General Audrey Azoulay on the International Literacy Day. https://www.unesco.org.tr/Home/AnnouncementDetail/6183
  38. Sajjadian, F., Amiri-Farahani, L., Haghani, S., Pezaro, S. (2024). Investigating the relationship between health literacy and preconceptual care components during the first 14 weeks of pregnancy: A cross-sectional study. BMC Primary Care, 25, 209. https://doi.org/10.1186/s12875-024-02467-5
  39. Elbarazi, I., Alam, Z., Ali, N., Loney, T., Al-Rifai, R. H., Al-Maskari, F., Ahmed, L. A. (2024). Health literacy among pregnant women in the United Arab Emirates: The Mutaba’ah study. Women’s Health, 20, 17455057231224179. https://doi.org/10.1177/17455057231224179
  40. Dolatabadi, Z., Farahani, L. A., Zargar, Z., Haghani, S., Mousavi, S. S. (2025). Disrespect and abuse during childbirth and associated factors among women: A cross-sectional study. BMC Pregnancy and Childbirth, 25, 229. https://doi.org/10.1186/s12884-025-07369-7