From clinic to classroom: Reframing health literacy as a foundational component of health systems

Health literacy is widely recognized as a determinant of health outcomes, and international organizations have increasingly advocated its integration into education systems through whole-school approaches. Navigating the modern healthcare system requires competencies that extend beyond basic reading ability, including numeracy, risk interpretation, and critical evaluation of health information. These skills are rarely systematically cultivated within formal education systems, leaving many individuals expected to develop them only when confronted with illness or complex medical decisions. Translating existing recommendations into sustainable practice requires more than curriculum reform alone. It requires schools that are organizationally equipped to develop health literacy systematically across the life course. We propose that health-literate schools should be viewed as organizational infrastructure for health systems and present a three-level implementation framework leading to population and health-system outcomes. The framework links cross-sector governance, organizational health literacy of schools, and student health literacy competencies. This perspective offers a practical pathway for strengthening population health, improving health system resilience, and reducing health inequities.