Book excerpt: The report identified policies and other relevant documents through an evidence review of peer-reviewed and grey literature supplemented by an enquiry of experts in health health literacy and policy in the Region and by health literacy policies included in the most recent peer-reviewed document on health literacy activities published in the Region (European Union (EU) countries only: HEALIT4EU). Further efforts to identify policies from countries of the Commonwealth of Independent States were unfruitful. Based on this evidence synthesis the following policy considerations are proposed: - consider the existing policies and related activities gathered in this review to develop or enhance health literacy policies and related activities to benefit citizens patients and communities; - broaden the range of areas of activity required for holistic health literacy policies to include the lived environment the workplace the media and digital/e-health at all societal levels ? individual community organization and system (legislative); - strengthen the evidence base for health literacy at all societal levels to ensure that policies address needs specific to the national or local context; -incorporate robust qualitative and quantitative evaluations into health literacy policies and interventions ? quantitative methods could include pre- and post-activity health literacy evaluations of evidence of health social and economic effects at all levels; and ?incorporate facilitators of successful implementation such as intersectoral working political leadership and strategies to overcome cultural barriers into health literacy policy. Member States would benefit from adopting such comprehensive frameworks and using metrics to design effective policies that support the development of a health-literate Europe.