Health literacy is a foundational driver of health equity, yet most efforts have focused on individual skills or clinical communication rather than the organizational systems that shape how people access and use health information and services. Organizational health literacy (OHL) offers a systems-level approach that expands responsibility to include organizations and systems. OHL emphasizes this responsibility between and across individuals, organizations, and broader systems by cultivating systems level focus on designing policies and practices that are easy to navigate and use. This case study describes the development, implementation, and early lessons from a large suburban county health department’s Health Literacy Initiative. Using a practice-informed, user-centered design process grounded in the literature and stakeholder input, we developed an open-access toolkit and complementary learning resources organized around six core domains: leadership and organizational transformation; health-literate workforce development; partnerships and intersectoral collaboration; accessibility of information and services; communication practices and standards; and community engagement and ou
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