What works to improve health and digital health literacy in disadvantaged groups: A policy-focused evidence brief.

The policy challenge: Low health literacy disproportionately affects disadvantaged populations and is associated with poorer health outcomes and reduced engagement with health services. Functional literacy skills, such as reading, writing, and numeracy, underpin health literacy and is shaped by cultural and socioeconomic factors. As digital health technologies become more widespread, digital health literacy is increasingly important; however, both low digital health literacy and digital exclusion can limit access to and engagement with health information and services, potentially exacerbating existing inequalities. Here, we review key policy-relevant evidence of what works to improve health and digital literacy for disadvantaged communities. Key evidence to inform policy: This evidence brief synthesises findings across four key population groups: people from low socioeconomic backgrounds, ethnic minority communities, older people with low digital literacy, and people with mental health conditions. Across populations, successful literacy interventions tailored information to the cultural and social needs of their target users, engaged and co-produced with communities in real-world settings, used audiovisual information to improve accessibility and focused on empowering users. Effectiveness in the context of intensity, i.e. contact hours, or intervention type was dependent on population groups studied. Evidence on digital health literacy interventions highlights the importance of usability, skills development and integration with existing health services, although consideration of digital health literacy in intervention design remains inconsistent. There is moderate evidence that health literacy interventions improve knowledge and skills, with mixed evidence for effects on behaviour and service use, and limited evidence for sustained improvements in clinical outcomes. Further considerations and implications: Health and digital health literacy are important drivers of health inequalities, influencing access to, engagement with and experience of health and care services. Interventions are most effective when delivered across individual, organisational and system levels. Policymakers should prioritise culturally tailored, accessible and community-based approaches, while also addressing structural barriers such as digital exclusion. Further research is needed to strengthen the evidence base, particularly on long-term clinical outcomes and implementation in diverse contexts.