Mapping health literacy to assist neighbourhood level interventions and support urban health equity

Low health literacy is a well-established driver of health disparities. To reduce these disparities, targeted interventions are needed to help people access, understand and use health information effectively. However, designing such interventions requires community-level health literacy data, which is often unavailable. This creates challenges for urban public health services in effectively tailoring and prioritizing interventions. To overcome this problem, the municipal public health service in Rotterdam developed an interactive neighbourhood health literacy dashboard, using available statistics and national health monitor data available at community level. The dashboard was designed to support the Healthy Neighbourhood Approach by identifying the places where additional outreach, understandable communication and tailored prevention may be most needed. It makes use of proxy indicators linked to health literacy, such perceived health and other relevant health and socioeconomic characteristics. These indicators were weighted based on literature and expert opinion and combined into a neighbourhood health literacy score. By combining multiple indicators, the dashboard facilitates the identification of areas where residents are more likely to face health literacy related barriers. The dashboard showed clear differences between neighbourhoods, facilitating the selection of low-literacy neighbourhoods. In practice, the dashboard was utilized within the Healthy Neighbourhood Approach and helped guide more targeted outreach, communication and prevention efforts. When direct data on health literacy are lacking at community level, proxy indicators can help identify where barriers are most likely to occur. This makes health literacy more actionable for local public health practices. A practical dashboard based on available health data can support more targeted and equitable interventions and may be useful in other urban settings facing similar data limitations.

Key messages

• A dashboard using proxy indicators can map health literacy gaps at neighbourhood level.

• Local health literacy data enables targeted, equitable public health interventions.