Indices Target date 2022 2030 1. Overall health literacy level (%) (proportion of people with basic health literacy) ≥22 ≥30 2. NCDs health literacy level (%) ≥20 ≥30 3. Nutrition knowledge awareness rate (%) 10% higher than 2019 10% higher than 2022 4. Mental health literacy level (%) 20 30 5. Environmental health literacy level (%) ≥15 ≥25
Table 1. Major outcome indices relevant to healthy literacy proposed in Healthy China Initiative (2019–2030).
Initiative Strategies and measures Health Literacy Initiative Health information development, dissemination, and supervision 1) Establish national and provincial expert libraries and resource libraries on health literacy improvement and conduct activities.
2) Build multimedia mechanisms for the release and dissemination of health information and strengthen guidance and supervision.
3) Apply new media such as WeChat, Weibo, and short videos and promote internet-technology-based precision delivery of health information.
Health education in healthcare services 1) Health professionals should have a good understanding about the health information that needs to be delivered to the patients, and actively provide health guidance to the patients.
2) Healthcare institutions should provide lectures and consultation services for community residents and patients.
3) Develop health education prescriptions and other materials.
4) Improve the contents of training courses and teaching materials for general practitioners and specialists and significantly improve family doctors’ knowledge and skills necessary for health promotion and education.
5) Establish incentive and evaluation mechanisms to encourage health institutions and healthcare providers to engage in health promotion and education.
Engagement of social forces 1) Mobilize social forces to join health literacy improvement by encouraging them to organize various forms of health education activities for the public and provide training to organizations.
2) All communities and workplaces should organize health communication activities such as health lectures for the residents and employees.
3) Improve health literacy for people living in poor areas.
Technologies and tools Develop and promote technologies and tools, especially encouraging the application of artificial intelligence and wearable devices in health management to improve self- management ability of the public. Health promotion programs/campaigns Establish Health Promotion County (or districts), carry out the Healthy China Campaign and the National Healthy Lifestyle Initiative. Health literacy in other initiatives Healthy diet initiatives 1) Strengthen guidance to food enterprises about nutrition label knowledge and guide consumers to read nutrition labels correctly.
2) Add mandatory labeling of sugar, encourage enterprises to become “low sugar” or “no sugar”, and actively promote the use of “front of package labeling (FOP)” information on food packaging to help consumers quickly choose healthy food.
Tobacco control initiatives 1) Promote a smoke-free culture, e.g. smoke-free weddings and smoke-free families.
2) Improve the content and form of health warnings on cigarette packaging.
Health promotion initiatives in schools 1) Set up health courses, teaching knowledge about health behavior and lifestyle, disease prevention and control, adolescent health, etc.
2) Provide various forms of health education for students and parents.
3) Train and cultivate health education teachers.
Health promotion initiatives for the elderly Provide educational activities and trainings for the elderly about fitness, disease prevention, treatment, rehabilitation, and health emergency skills for self-rescue and mutual aid etc.
Table 2. Examples of strategies and measures to improve health literacy in Healthy China Initiative (2019–2030).
“Healthy China 2030” has put forward goals and strategies to improve health literacy in China. Here are some suggestions for decision makers, practitioners, and researchers when pursuing this work:
1) It should be understood that improving health literacy is not only about improving skills of the patients or the public through education, but also improving health information and removing literacy-related barriers to health services, like reducing the complexity of health information, enhancing health professionals skills in health education, etc., about examining organizational and system-wide norms, policies, and regulations that influence the actions and resources of those seeking assistance and of those providing services (13).
2) Special attention and effort should be given to people with lower health literacy that are vulnerable to serious health disparities, such as rural residents, migrants from rural areas, elderly people, and people with low socioeconomic status. Specific strategies, programs, and research should be developed to address their barriers and needs in improving health literacy that demand the development of cross-sectoral, cross-disciplinary collaboration and the engagement of the community.
3) For patient education at clinical settings, health professionals should be sensitive to the patient’s health literacy level, and a rapid health literacy assessment is necessary for delivering tailored health education with suitable communication strategies. Effective educational and support models, such as peer-to-peer education and group care programs for chronic disease management, could be integrated within daily practice (1).
4) To support evidence-based health literacy practices, the joint development of a research plan on health literacy by public health workers, clinicians, and health literacy/education experts should be performed to identify the current gaps and outline the most needed areas of research in China.
Funding: This work was supported by the National Key Research and Development Program (2018YFC1311405).