[Navigational health literacy of the population in Germany]

Many health care systems are characterized by their high complexity and intransparency. Finding one's way through the multitude of services and finding the right place requires high navigational health literacy (NHL). NHL is defined as the ability to manoeuvre through the health care system and deal with the information required to do so. However, so far, there has been a lack of data on the population's NHL. The objective of this article is to analyse empirically the NHL in Germany and its association with socio-demographic and economic factors.

NHL was surveyed with an instrument (HLS₁₉-NAV) newly developed by an international working group, measuring the self-assessed difficulties in relation to 12 navigation-related information tasks. The HLS₁₉-NAV has already been used in 8 countries, including Germany. In Germany, data on NHL was collected from 2,151 adult residents in a representative cross-sectional study. The relationship between socio-demographic and economic factors, and NHL was examined by using methods of analysis of variance and multivariate linear regression analysis.

Approximately 80% of the respondents showed low NHL with a mean score of 41.5 out of a possible 100 points. Those with low socio-economic resources, people of advanced age, people who had migrated to Germany or who were limited by health issues had a particularly low NHL. However, even people with good resources had a relatively low NHL. In contrast, the mean score was significantly higher among health professionals.

In recent years, numerous efforts have been made to reduce navigational difficulties and to better guide patients through the German health care system. However, according to the results of the study, there is still need for further action. Above all, structural measures are required: this includes the creation of sufficient, reliable information on the health care system and its organizations as well as the implementation of navigation aids, health care pathways and the creation of a health-literate health care system including organizations and health professionals that contribute to strengthening NHL in general.