Book excerpt: Health literacy can be defined as the capacity of individuals families and communities to access understand appraise and apply health information in order to make judgements and take decisions in everyday life concerning health care disease prevention and health promotion in order to maintain or improve their quality of life. It is considered to be a social determinant of health and one of the key pillars in health promotion. Low health literacy is associated with poorer health more illness and health inequalities and it may make health systems less cost-effective. Evidence from the 2011 health literacy survey indicated that almost half of the adult population in eight Member States of the European Union had suboptimal general health literacy. Responses have included initiation of health literacy networks policies programmes and interventions at the regional national and organizational levels. These initiatives require monitoring using frameworks and indicator sets that produce consistent and comparable population data and evaluation to determine the effectiveness of the policies and interventions.