Health literacy in an urban elderly East-German population – results from the population-based CARLA study

Abstract

BackgroundHealth literacy (HL) has gained increasing attention in public health research. However, until now research was mainly focused on clinical settings rather than on the general population. Due its relation to social determinants and health outcomes, HL is of special interest in epidemiological studies. The aim of the present study was therefore to describe HL among an elderly general high-risk population, to analyze the potential contributing factors of HL, and to analyze the impact of HL on health-related outcomes.MethodsWe used data from the CARLA Study, which is a prospective population-based cohort study of the elderly general population of the city of Halle (Saale) in Eastern Germany. The short version of the HLS-EU Questionnaire (HLS-EU-Q16) was administered with 1,107 subjects aged between 55 and 91 year old. A HL score ranging from 0 to 50 points was computed and classified according to the recommendation of the HLS-EU project. Socio-economic as well as health-related variables were determined during the standardized interview and clinical examination. We calculated linear as well as logistic regression models in order to analyze the association between HL and health-related outcomes as well as potential influencing factors of HL.ResultsOverall, the HL score was 36.9 (SD 6.9). Among all subjects, 4 % showed inadequate HL, 23 % problematic HL, 50 % sufficient HL, and 23 % excellent HL. HL was positively associated with educational level, net household income, and self-perceived social position. Further, we found an increase of HL with age (β = 0.10; 95 % CL 0.05; 0.15) and a lower HL score among women compared with men (Diff = -1.4; 95 % CL −2.2; −0.6). An inverse association was observed between HL and diabetes among both sexes (OR 0.93; 95 % CL 0.93; 0.98), between HL and myocardial infarction among women, and between HL and stroke among men.ConclusionsIn this elderly general Eastern German population, we found higher HL score values compared with previous studies using the same questionnaire. HL was associated with socio-economic status. Furthermore, this cross-sectional study could show associations between HL and different health-related outcomes even after adjustment for educational level. However, further research is needed in order to evaluate the impact of HL on health-related outcomes using longitudinal data derived from the general population.

Health literacy and health among the elderly: status and challenges in the context of the Polish population aging process

“…To some extent this hypothesis can be supported by, the found in the Polish study, the phenomenon of increasing with age the impact of self -assessed social position on health self -assessment. The relationship between social position and health literacy were confirmed by other authors (van der Heide et al 2013;Tiller et al 2015;Furuya et al 2015).…”

Health literacy among different age groups in Germany: results of a cross-sectional survey

“…Overall, our study shows a higher proportion of limited perceived health literacy compared to European average [8] which might be explained by different demands and complexity of the health care systems. Our study shows a higher proportion of limited perceived health literacy than other findings from Germany [8, 12, 14]. However, these studies were restricted to the German state of North Rhine-Westphalia, a single region that is not representative for Germany [8, 9], or only used a short version HLS-EU questionnaire to measure health literacy which comprises only a selection of items of the full version [12, 14].…”

“…However, these studies were restricted to the German state of North Rhine-Westphalia, a single region that is not representative for Germany [8, 9], or only used a short version HLS-EU questionnaire to measure health literacy which comprises only a selection of items of the full version [12, 14]. Other studies were restricted to people with statutory health insurance [13], or older populations [12] only.…”

“…Results for health literacy in Germany are scarce. They focus on certain subgroups only [9, 12, 13] or use a short version to measure health literacy [14]. There is also evidence that health literacy declines with increasing age [8].…”

Health literacy: content of the concept

“…По мнению специалистов в области общественного здоровья и здра-воохранения, необходимо изучать уровень HL для разра-ботки эффективных мер укрепления здоровья населения и сокращения социально-экономического неравенства в отношении здоровья [15,16].…”