Health Literate Schools Framework: Improving School Health Literacy to Increase Health and Education Outcomes
By: Orkan Okan
Societies need their education systems to adopt a systematic health literacy strategy for schools and teacher training. Health literacy is a critical determinant of health and well-being for children and adolescents. Low health literacy among youth, especially those from disadvantaged backgrounds, is linked to poorer health behaviors and outcomes, as well as lower educational achievement. Equipping children and adolescents with health literacy skills is essential for helping them identify misinformation, critically navigate complex online health information environments, and recognize and resist the influence of commercial determinants of health within today’s rapidly evolving information ecosystems. Schools offer a unique setting to address these challenges – not only by strengthening the personal health literacy of students, but also by becoming organizations that actively foster health literacy through their structures, processes, and culture, i.e., health literate schools. The World Health Organization emphasizes that a whole-of-school approach, targeting both individual skills and the environment, is essential to reduce health inequalities and promote equity.
Why Organizational Health Literacy in Schools?
While traditional interventions often focus on teaching students about health, research increasingly shows that sustainable improvements require schools themselves to become health-literate organizations. This means creating a responsive environment where everyone – students, staff, and families – can learn about the knowledge and skills required in life to access, understand, evaluate, and use health information effectively. The Health Literate School Framework (HeLit-Schools) was developed to guide this transformation, providing a comprehensive structure for schools to self-assess and enhance their organizational health literacy.
The Eight Standards of a Health Literate School
The HeLit-Schools framework defines eight quality standards, each supported by six indicators, that together describe what it means for a school to be health literate:
1. Include health literacy into the school’s mission statement
2. Health literacy as part of school development
3. Promote and enhance health literacy in daily school life
4. Health literacy of students
5. Health literate school staff
6. Health literate communication at school
7. Enhance health literacy in the school environment
8. Networking and cooperation
These standards and indicators enable schools to assess their strengths and identify areas for improvement. To make use of existing whole-of-school approaches and avoid duplicity, the HeLit-Schools frameworks can be easily linked or integrated with the Whole School, Whole Community, Whole Child (WSCC) framework and the Health Promoting School framework, as all three emphasize a comprehensive, collaborative approach that aligns health and education policies, practices, and community engagement to support the well-being and academic success of every student
Impact and Recommendations
Implementing the HeLit-Schools framework can play a pivotal role in reducing health inequalities by addressing both individual and systemic determinants of health literacy. By embedding health literacy into all aspects of school life, schools can empower students to learn how to make informed health decisions, improve academic performance, and enhance their overall well-being. The WHO recommends that successful implementation requires strong leadership, ongoing professional development for staff, collaboration with families and communities, and the integration of health literacy into school policies and curricula. To ensure sustained progress and meaningful change, it is essential to develop and implement a robust monitoring mechanism that continuously assesses school health literacy – including personal, professional, and organizational health literacy – at local, national, and regional levels, enabling stakeholders to identify gaps, share best practices, and drive ongoing improvement.
In summary, fostering both personal and organizational health literacy in schools is a powerful strategy to promote equity, improve health outcomes, and prepare young people for the challenges of modern life. The HeLit-Schools framework provides a practical, evidence-based approach for schools to become truly health literate, benefiting students, staff, school, and the wider community.
About the Author:
Dr Orkan Okan is professor of health literacy at the TUM School of Medicine and Health and the Department of Health and Sport Sciences at Technical University of Munich, Germany, and head of the WHO Collaborating Center for Health Literacy. Orkan has a background in education and public health. His research covers health literacy in society and in different settings, focusing on disease prevention, health promotion, health care, and digitalization. His interdisciplinary research has a particular focus on children, adolescents, and schools. He is currently involved in various national and international projects and advises and works with (non-)governmental organizations. He has edited several books on health literacy, including the International Handbook of Health Literacy. Orkan is president of the International Health Literacy Association, president of the EUPHA Health Literacy Section, co-chair of the IUHPE GWG on Health Literacy, and co-founder and co-chair of the Global Health Literacy Research Network.
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