WHO health literacy standards for adolescents and emerging health risks: a systematic review

Abstract

Abstract Background Adolescents are increasingly exposed to digital media environments that shape their health-related decisions. In this context, they are also exposed to misinformation, unhealthy product marketing, and other commercial determinants of health. These threats collectively represent the emerging health risks (EHR) that affect their physical, social, and mental well-being. Despite the growing importance of health literacy (HL) as a public health priority, guidance for school curricula that prepare adolescents to critically navigate EHRs remains lacking. This systematic review aims to provide an overview of existing HL standards as a basis tostandards for adolescents to address EHR. Methods A systematic literature search was conducted in PubMed, Scopus, and Web of Science from 2010 onwards. Studies were eligible if they reported HL competency frameworks targeting adolescents aged 10–19 years, delivered in school or digital settings, and from any region of the world. Results Out of 1320 identified studies/reports, 27 were finally included. Studies came from 13 countries, with the USA and Germany being the most represented (22.2% and 18.5%, respectively), the majority were from high-income countries (66.6%). Frameworks addressed numerous topics, with infodemic and misinformation constituting the primary focus at 44.4%, followed by climate and environmental risks at 14.8%. Additional subjects were addressed less frequently, including NCD burden, commercialism, and war and conflict. Conclusions Most existing frameworks are heavily concentrated in high-income countries, raising concerns about their global applicability. The dominant focus was misinformation and infodemic risks, while climate, commercialism, and conflict-related risks remain underrepresented. Therefore, this review will inform the development of WHO HL competency standards, designed to equip adolescents with critical skills to navigate the full range of EHRs. Key messages • This review informs the development of a WHO-aligned health literacy competency framework offering age-appropriate standards for adolescents to navigate emerging health risks across diverse settings. • Frameworks disproportionately originate from high-income countries, underscoring the need for globally adaptable HL competency standards for adolescents.