Orkan Okan, Andrea Sylvia Winkler
This perspective examines health literacy through a One Health lens, emphasizing its relevance for developing One Health-literate citizens, as advocated by the Lancet One Health Commission's recommendation on school health literacy. It argues for a comprehensive understanding of health literacy across the socioecological continuum, integrating both individual agency and structural influences. Rather than viewing low health literacy as an individual deficiency, this perspective situates it within broader systemic and contextual factors, particularly pertinent to low- and middle-income countries and underserved populations. Building on this premise, the Health-Literate School (HeLit-School) framework offers a whole-of-school approach to advancing health literacy by embedding the concept of organizational health literacy within school systems. Drawing on socioecological and organizational development principles, HeLit-School fosters institutional transformation across all levels of school development, supporting the implementation of holistic, multi-level interventions to enhance health literacy in the school setting. It highlights the critical roles of principals and the importance of adequate resources as structural enablers of sustainable health promotion within educational settings. This perspective calls for integrating agency-based, behavioural approaches with structural, determinant-oriented strategies to strengthen both personal and organizational health literacy in schools. Aligning One Health principles with the HeLit-School framework helps bridge the behavioural and environmental determinants of health. The proposed adaptation of HeLit-Schools for One Health and its contextualization in low- and middle-income countries illustrate how upstream, setting-based interventions can support systemic capacity-building and the formation of health-literate students, educators, and policymakers in relation to One Health.