However, a study examining interactive and critical health literacy skills in the European Union replicated functional health literacy findings in England and found that people with low skills in these areas also made more use of hospital services, were less likely to get involved in preventive activities and were more likely to die at a younger age85 than those with better skills. Although we can infer that the associations between functional health literacy and health outcomes are likely to persist when interactive and critical health literacy skills are taken into account, more evidence, based on the UK population, is required to provide firm evidence of this association.