Background and Objective:
Health literacy is a key enabler to accelerating progress towards noncommunicable diseases targets in the Sustainable Development Goals. Gaining an understanding of people’s health literacy strengths, needs and preferences provides insight into whether individuals can access, understand, appraise, remember or use health information or engage with health services. Using health literacy as a measurable multidimensional concept, we aimed to identify priority groups of migrants at risk of poor health and equity outcomes.

Methods:
We combined quantitative and qualitative cross-sectional data of 1126 migrants living in Portugal. Quantitative assessments used the Health Literacy Questionnaire (HLQ), with nine distinct dimensions and sociodemographic variables. Descriptive and hierarchical cluster analyses were performed to characterise and generate profiles of groups with similar health literacy patterns. Semi-structured interviews were conducted with 15 migrants, stratified by the identified clusters.

Results:
We found 16 distinct profiles with different patterns of health literacy strengths and needs. While 11 profiles revealed strengths in ‘finding health information’ (74.8% of migrants) and ‘understanding health information’ (73%), 75.4% of the participants from 13 profiles experienced difficulties (low to very low scores) regarding ‘health provider support’. Notably, 36.8% (6 profiles) exhibited challenges across many health literacy domains. The interviews revealed that migrants experienced multiple barriers regarding accessing information and services, including service responsiveness, trust and rapport with health care professionals, cultural safety, stigma, and language. A key enabler in relation to health information and service access and engagement was the perceived support from family and peers.

Conclusion:
The identification of profiles proved useful to target underserved groups of migrants that are being left behind and not receiving or easily accessing health information or health care. Tailored health literacy-informed strategies that use strengths-based approaches and are informed by peoples needs and preferences can potentially be more effective and equitable.