Trends in Digital Health Literacy: Results of the Third Health Literacy Survey in Germany.

BACKGROUND

There have not been any studies to date on trends in digital health literacy (DHL) in Germany. We studied trends in DHL and relevant factors that affect it on the basis of two population-based surveys conducted in 2019/2020 and 2024/2025.

METHODS

Data from the second and third Health Literacy Surveys in Germany (HLS-GER 2, 2019/2020; HLS-GER 3, 2024/2025) were evaluated. Subjective difficulty with digital health information was measured with the HLS19-DIGI survey instrument in two personal cross-sectional surveys of the adult, German-speaking population of Germany.

RESULTS

In HLS-GER 3, 71.1% of respondents had low DHL; this was an improvement compared to 75.8% in HLS-GER 2 (p <0.05). Nonetheless, social and age-related disparities widened. Lower DHL displayed small to moderate associations with older age (β = -0.235; p <0.001) and financial deprivation (B = -5.285; p = 0.001); higher DHL was associated with a higher level of education (β = 0.087; p < 0.001), higher social status (β = 0.086; p < 0.001), and better literacy skills (β = 0.071; p < 0.001). Moreover, self-efficacy (β = 0.233; p <0.001) and more frequent use of health-related websites (B = 15.227; p <0.001) were associated with a higher DHL.

CONCLUSION

Fostering DHL is essential in view of the expansion of digital health information and the increasing amount of false and misleading information in the electronic media. Important tasks include reducing social and digital inequities and improving the quality of digital information.