1. Health literacy as a determinant of health

HL is closely intertwined with social determinants of health, such as age, education, employment, and socioeconomic status [14–19]. For example, Riiser et al. explored HL among adolescents and its impact on their quality of life [14]. Chidambaram et al. further highlighted the role of socio-demographic, economic, and political factors in shaping individuals’ interactions with the digital healthcare system and building digital HL, also known as digital determinants of health (DDOH) [16]. Another study by Arias López and colleagues emphasized the importance of digital HL in the era of modern technology for better self-management, and participation in healthcare decision-making to improve quality of life [15].

HL-related knowledge and skills enable individuals to identify health risks, adopt protective measures, and effectively manage their health problems. Improved HL empowers individuals to make informed choices that support their well-being. For example, Miyoshi & Watanabe’s path analysis explored how genomic knowledge, health numeracy, and interactive HL predict individuals’ risk perception and healthcare decisions for treatment [20]. Additionally, Sargsyan et al. accentuated the effects of socio-demographic factors on HL, found that these factor shape health knowledge and behavior in adopting better preventive practices [19]. Furthermore, Bailey et al. highlighted that a lack of knowledge about medication overdoses, especially among older adults and minorities, indicates low HL, leading to adverse health outcomes and medical complications [21]. These findings underscore how HL shapes personal health choices, health behavior, and their consequences.

Individuals from underdeveloped backgrounds often have limited opportunities for education, employment, and financial stability, contributing to lower HL. Conversely, individuals with higher HL tend to engage in healthier behaviors, such as preventive screenings, a healthy diet, and regular exercise [17,18]. Higher HL is imperative for older age groups and individuals with chronic diseases like diabetes and hypertension to reduce mortality and promote healthy outcomes [17,18]. Moreover, studies from Sweden [22] and Switzerland [23] highlight that low HL disproportionately affects migrant refugees and socioeconomically disadvantaged individuals [22,23]. Due to social exclusion and marginalization, these groups face additional barriers to accessing healthcare information and services, including language barriers, limited education and employment opportunities, fewer housing facilities, and cultural differences. Financial deprivation is a critical factor contributing to marginal HL, leading to poorer health experiences, such as increased hospitalization rates and decreased adherence to treatment regimens.

2. Health literacy and access to healthcare

Limited HL significantly hinders individuals’ access to necessary healthcare services. This can lead to difficulties in navigating the complex hierarchy of healthcare systems, understanding medical terminologies, and prescriptions, and managing health conditions [24,25]. These challenges may result in delayed diagnosis, inappropriate or untimely treatment, and deteriorated health outcomes, consequently exacerbating health inequalities. This is particularly evident in the case of differently-abled individuals, e.g., the deaf community, who face significant barriers in accessing healthcare information and services, often leading to suboptimal health outcomes [26].

Disparities in education, healthcare access, and digital resources also affect HL levels. Epidemiological and cluster analyses revealed that younger, educated individuals tend to have higher HL compared to older, less-educated individuals, creating structural barriers. Nam & Yoon emphasized the mediating role of access to healthcare, provider-patient interaction, motivation, self-efficacy and self-care behavior among diabetes patients with physical disabilities, highlighting how HL can improve patient autonomy and health management [25].

Additionally, parents’ limited knowledge coupled with digital HL emerge as a significant barrier to access to healthcare services. For instance, parents’ ability to assess vaccine-related health information can significantly impact their decision-making regarding vaccine uptake for their children [27]. However, trust in healthcare providers remains a crucial factor for parents’ healthcare decisions.

Another dimension of healthcare access relates to healthcare professionals, who play a pivotal role in improving HL through health education and shared decision-making opportunities [28]. Healthcare providers can enhance HL and health education by using simple language, avoiding medical jargon, and actively listening to their patients’ concerns to facilitate informed decision-making. Improved self-perceived health is closely linked to higher HL. To address these challenges, targeted interventions aimed at improving access to healthcare for vulnerable populations are essential.

3. Health literacy-related interventions

Promoting HL is crucial for individuals’ informed participation in healthcare and reducing health inequalities. However, various challenges hinder HL, necessitating interventions to address these challenges and propose effective solutions. Several interventions have been developed to improve HL, including educational programs, digital tools, and community-based initiatives [29–31]. Digital learning resources provide accessible and engaging ways for individuals to acquire health information and develop critical thinking skills. Hall et al. highlighted the role of visual and pictorial communication in enhancing HL and influencing individuals’ behavior change [30]. Furthermore, a culturally sensitive approach from healthcare providers can facilitate effective communication and understanding among patients from diverse backgrounds.

To improve HL of marginalized communities, Hosking et al. and Windfall et al suggested that school-based peer education and training of local community health workers can be highly effective [31,32]. Community health workers, being indigenous and culturally sensitive, can provide culturally relevant health information and support, effectively bridging the gap between healthcare providers and patients. It’s pertinent to mention that most studies in this curated collection recommend targeted interventions to improve the HL of the general population and patients to maintain a better quality of life.

In the modern era, the increased use of digital technology in healthcare has led to the emergence of digital HL, which refers to the ability to access, understand, and utilize digital health information and tools [16]. As our world becomes increasingly digitized, it is imperative for all individuals to develop the necessary knowledge, competencies, and skills to effectively navigate digital health resources.

4. Health literacy and policy integration

Local governments and healthcare systems play a crucial role in addressing HL challenges, with a focus on integrating HL into public health policies and programs [33]. Implementation of health promotion and HL initiatives within the educational system has the potential to build and enhance HL [33]. However, there is a pressing need to establish strong policy foundations for HL and embed its significance into the strategic documents and operational plans of healthcare systems.

Notably, this collection informed various challenges in implementing effective HL policies, including resource limitations, disparities in digital access, and socio-political factors [16]. In some settings, cultural barriers and language differences may hinder the efficacy of HL interventions [15,26,32].

The role of government and policymakers is pivotal in raising awareness about HL, securing adequate funding, promoting health equity, and improving positive health outcomes across all age groups. Initiatives such as school-based programs can help to improve HL among younger populations. There is also a need to develop a robust evaluation framework and mechanisms to measure the impact of HL interventions.