Objectives: Examining whether specific population groups who are not working and those who have an employment have the same health literacy level.Methods: Data were retrieved from a nationally representative cross-sectional study of the Danish population conducted with the health literacy questionnaire (HLS-EU-Q16) in 2016 and 2017. Socio-demographic characteristics were drawn from national registers. Odds ratio for the association between employment status and health literacy was estimated from logistic regression models, adjusted for socio-demographic characteristics. Probability weights were used to adjust for differences in responses.Results: Logistic regression analyses showed that receiving unemployment benefits, social assistance, employment and support allowance, retirement pension and sickness benefit were significantly associated with having inadequate health literacy compared to being employed in any industry. The highest odds ratio for inadequate health literacy was present for receiving unemployment benefit OR = 1.78 (95% CI: 1.23–2.56).Conclusion: Population groups not working and receiving economic public support have higher odds of inadequate health literacy competencies compared to those active in the labor force, considering age and socioeconomic factors. The result contributes to understanding health disparities in connection to occupational situation.

Aim: This study investigates the non-medical public health and surveillance policies and actions for tackling the community spread of COVID-19 pandemic in Denmark, Serbia and Sweden during the first five months of the pandemic in 2020. Method: The study is inspired by a process-tracing design for case study with a focus on the non-medical measures and surveillance strategies implemented by the three countries. The comprehensive collection and study of national documents formed the basis of the document analysis. Results: The Danish strategy was to prolong the transmission period, preventing high numbers of infected cases from impacting their healthcare capacity. The government’s strategy was characterized by strict governance elements, health guidelines and behavioural recommendations. In Serbia, the main strategy was to prevent the spread and control of the infectious disease by shifting all human and material resources towards the function of controlling the spread. Serbia applied the strictest measures in the fight against coronavirus in relation to other countries in the region and in Europe. The Swedish strategy focused more on recommendations than requirements to motivate the public to modify their behaviours voluntarily. Sweden’s loose pandemic strategy implementation focused on voluntary and stepwise action rather than legislation and compulsory measures. Conclusions: The public health policies and actions implemented to prevent community spread of COVID-19 in Denmark, Serbia and Sweden varied during the first five months of the pandemic. The differences in their response were due to delays in implementation, inconsistencies in perspectives towards the outbreak and the capacity of each country in terms of their pandemic preparedness and response.

Background It is well known, that health literacy is associated with health, and that occupation and health is associated as well. But current knowledge on the relationship between occupation and health literacy is scarce. The aim of this study was to examine the association of occupation with health literacy. Methods Between 2016 and 2017 a random sample of the Danish population participated in a cross-sectional national representative survey using the short version of the European Health Literacy Survey Questionnaire. 15,682 adults aged 25 years or older was invited, and 8,997 residents participated. Data on occupational situation were obtained from nationwide administrative registries, which contains information on employment and public benefits. Logistic regression was conducted for the binary outcome of health literacy and the exposure variable of occupational situation. Model was adjusted for sex, age, immigration, education, cohabitation and income. Subsequently, a mediation analysis was conducted to analyze if health literacy was a causal pathway in the association between occupational situation and health. Results Respondents receiving unemployment benefits had a significantly higher risk of inadequate health literacy [OR = 1.66 (p < 0.001)] compared to respondents who were employed. The associations were also significant for social assistance [OR = 1.63 (p < 0.001)], employment and support allowance [OR = 1.59 (p < 0.001)], and sickness benefit [OR = 1.55 (p < 0.001)]. Mediation analysis showed, that the association between employment status and health were partly mediated by health literacy. Conclusions Results are important to understand the health disparities in connection to occupational situation, health literacy, and health. As a mean for health promotion, interventions to improve health literacy should be planned for groups receiving public benefits and when health information is delivered for these groups the level of health literacy should be considered. Key messages Association between employment status and health were partly mediated by health literacy. Interventions to improve health literacy should be planned for groups receiving public benefits.