I am a Queen’s Nurse and Nurse Lecturer. I also volunteer at a National Lottery Community Fund–funded “Warm Space” at Pineapple House in Stirchley, Birmingham, where I deliver a term-time story session for children aged 0–5 years and their families. This provides an accessible and inclusive space that promotes learning, wellbeing, and community connection.

Story reading in the early years provides a clear example of how social determinants of health and health literacy intersect. Children under five rely on their environments and caregivers to support language development and early understanding. Access to books, opportunities for shared reading, and exposure to rich language vary considerably across communities, often reflecting wider inequalities. These differences can lead to variations in early communication skills, which in turn influence a child’s ability to understand information, engage with learning, and later interact effectively with healthcare services.

The story sessions provide children with regular exposure to books and spoken language in a supportive, informal setting. They also enable parents and carers to engage in shared reading, modelling communication, interpretation, and discussion. This is particularly important where families may have limited access to resources or confidence in supporting early learning at home. In this way, community-based story sessions act as an early intervention, helping to reduce the impact of social disadvantage on language development and supporting the conditions in which health literacy can develop.

Effective health literacy relies on strong spoken and written language skills and overall literacy. Children who develop strong communication skills are better able to understand explanations, follow guidance, and participate in dialogue as they grow. These abilities are essential for future interactions with healthcare professionals, including describing symptoms, asking questions, and making sense of advice related to prevention and treatment. Story reading supports the development of vocabulary, comprehension, and reasoning skills, all of which contribute to an individual’s capacity to engage with health information across the life course.

Health literacy is also socially constructed within families and communities. Story sessions encourage interaction between children and caregivers, creating opportunities for conversation, questioning, and shared understanding. These interactions can strengthen parental confidence in communicating with children about everyday experiences, including health and wellbeing. They also reinforce the role of the home environment in shaping how information is understood and used. Social factors such as parental education, confidence, and access to supportive networks all influence these processes, highlighting the broader context in which health literacy develops.

Inequalities in access to early learning opportunities, including books and safe community spaces, contribute to differences in health literacy across populations. Community initiatives such as Pineapple House play an important role in addressing these disparities by offering free, inclusive, and non-stigmatising access to early literacy experiences. By embedding learning within a community setting, they also promote social connection and engagement, which are important components of overall wellbeing.

For primary care nurses, recognising the relationship between social determinants of health and health literacy highlights the importance of working beyond traditional clinical settings. Community-based activities such as story sessions offer opportunities to support families through early intervention, reinforce health messages in accessible ways, and strengthen links between services and communities. They also provide a foundation for approaches such as social prescribing and partnership working, which aim to address the wider factors influencing health.

In summary, story reading for children under five demonstrates how health literacy is shaped by social determinants of health and developed through everyday interactions within families and communities. By supporting language development, encouraging family engagement, and improving access to learning opportunities, community-based story sessions contribute to building the skills and confidence needed to engage with health information. For primary care nursing, they represent an important component of preventative care and a practical approach to reducing health inequalities over the life course.