The first European comparative survey on health literacy in populations,  carried out in eight European countries (Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain) showed that health literacy levels differed both between countries and between population subgroups within each country. It highlights the low levels of health literacy in subgroups with low economic resources, low education compared to the rest of the population, and low levels of health literacy in subgroups with financial deprivation, low social status, low education or old age, compared to the rest of the population. Is is conclude that the social gradient in health literacy needs to be taken into account when developing public health strategies to improve health equity in Europe.