Health Literacy Around the World: Part 1 1 Health Literacy Efforts Outside Of the United States by Andrew Pleasant, Ph.D. Director of Health Literacy and Research Canyon Ranch Institute Tucson, Arizona U.S.A. Commissioned by Institute of Medicine Roundtable on Health Literacy 1 The author is responsible for the content of this article, which does not necessarily represent the views of the Institute of Medicine 1 Table of Contents TABLE OF CONTENTS ............................................................................................................................................ 2 ACKNOWLEDGEMENTS ........................................................................................................................................ 3 INTRODUCTION ....................................................................................................................................................... 4 HEALTH LITERACY: A BRIEF SYNOPSIS OF THE FIELD ............................................................................................... 4 METHODOLOGY ...................................................................................................................................................... 7 RESULTS ................................................................................................................................................................... 10 Austria ................................................................................................................................................................ 10 Australia ............................................................................................................................................................. 11 Bangladesh ......................................................................................................................................................... 23 Botswana ............................................................................................................................................................ 23 Brazil .................................................................................................................................................................. 24 Cameroon ........................................................................................................................................................... 24 Canada ............................................................................................................................................................... 25 Chile ................................................................................................................................................................... 33 China .................................................................................................................................................................. 34 Cote d’Ivoire ...................................................................................................................................................... 38 Denmark ............................................................................................................................................................. 39 Finland ............................................................................................................................................................... 40 Greece ................................................................................................................................................................ 41 India ................................................................................................................................................................... 42 Ireland ................................................................................................................................................................ 45 Israel .................................................................................................................................................................. 48 Japan .................................................................................................................................................................. 50 Kenya ................................................................................................................................................................. 51 Liberia ................................................................................................................................................................ 53 Malawi ............................................................................................................................................................... 53 Mexico ................................................................................................................................................................ 54 Mozambique ....................................................................................................................................................... 56 New Zealand ...................................................................................................................................................... 56 Netherlands ........................................................................................................................................................ 60 Pakistan .............................................................................................................................................................. 60 Peru .................................................................................................................................................................... 61 Singapore ........................................................................................................................................................... 63 Slovenia .............................................................................................................................................................. 63 South Africa ....................................................................................................................................................... 64 Spain .................................................................................................................................................................. 66 Switzerland ......................................................................................................................................................... 67 Turkey ................................................................................................................................................................ 68 United Kingdom (Great Britain, Scotland, Wales, and Northern Ireland) ........................................................ 69 Zimbabwe ........................................................................................................................................................... 73 European Union (EU) ........................................................................................................................................ 74 United Nations (UN) .......................................................................................................................................... 77 International Non-Governmental Organizations (in alphabetical order) .......................................................... 80 PRELIMINARY SUMMARY AND CONCLUSIONS .......................................................................................... 83 REFERENCES .......................................................................................................................................................... 87 2 Acknowledgements First and foremost, I want to offer my sincere gratitude to every participant who took the time to respond to the request for information. When investigating what is essentially an unknown phenomenon such as the subject of this commissioned paper, it becomes increasing difficult to design an efficient data collection tool. The data collection tool employed in this exercise inherently had no choice but to place the bulk of the burden on respondents to respond in English. I dearly wish that reliance on the English language and the burden created by an open-ended inquiry could have been reduced. However, the resources available, the context of health literacy as a field of research and practice, and my own personal skills required an open-ended inquiry in English. Truly, and necessarily, this was not a health literate process of collecting information. I had to rely on the motivation and health literacy skills, in English, of the respondents. Thus, I cannot thank the participants enough. This effort would also not have been possible without the inspiration and support from the staff and members of the U.S. Institute of Medicine Roundtable on Health Literacy. In particular, I would like to recognize the tireless role that Lyla Hernandez plays in keeping the Roundtable on Health Literacy moving forward. While many of the many hours I had the pleasure to invest in this project occurred in the evening and weekends, many hours also necessarily overlapped with my primary employment at Canyon Ranch Institute (CRI), which is a 501c3 non-profit public charity located in Tucson, Arizona in the United States. Without the active support of my colleagues at CRI,