gms | German Medical Science

Background: The COVID-19 pandemic has put health information at the center of society's attention. The WHO even refers to it as an “infodemic”. Health literacy (HL) is therefore more important than ever, so the question arises as to what extent the population is able to deal with health information in this situation.

Objectives: This study compares the general and digital HL of the German population before the outbreak of the COVID-19 pandemic and during its persistence. In addition, different changes in population groups are studied.

Methods: The analyses are based on the Second Health Literacy Survey Germany (HLS-GER 2) and an additional study (HLS-GER 2’). The 18+ years population representative cross-sectional data were collected in Dec/Jan 2019/2020 before (N=2051) and Aug/Sep 2020 during (N=532) the pandemic with personal interviews (PAPI). General and digital HL were measured using instruments which were also applied in the Health Literacy Survey 2019–2021 (HLS19), which the HLS-GER 2 is part of. Bivariate analyses were used to describe changes between time points and within groups.

Results: On average, the HL of the population in Germany improved slightly during the pandemic. This effect is especially evident with regard to the evaluation of health information and in the area of digital HL. Women, people with low or medium education, younger and migrated people appear to have benefited more than average. Conversely, older persons didn’t benefit. Among persons with several chronic diseases HL even worsened.

Discussion: The systematic exposure to clearly structured and continuously repeated health information as it was the case during the COVID-19 pandemic seems to have improved the ability to process health information in the German population. In particular, there has been an increase in competence in dealing with digital information media, which are increasingly used to communicate health information. However, there are partly large differences between different population groups. Older people and those with several chronic diseases – who tend to be at greater risk of severe COVID-19 courses – have far greater difficulties in dealing with health information, which became even more apparent during the course of the pandemic.

Practical implications: From a public health perspective, it is important to observe this development in more detail to clarify to what extent the changes described will remain valid after the pandemic. With regard to intervention development, it once again points to the great importance of target-group-specific intervention strategies that are tailored to the specific situation of the recipients. This is particularly important for population groups at higher risks, such as people in old age and those with multiple chronic conditions.

Take away message: The study provides evidence that health literacy can improve through the continued presence of specific health information and an increased use of digital health services, although this does not apply to all populations.