Modifiable predictors of health literacy in working-age adults - a rapid review and meta-analysis

Abstract

Background Health literacy comprises the ability to identify, obtain, interpret and act upon health information. Low health literacy is a major risk factor for hospitalizations, use of emergency care and premature mortality among others. Known risk factors for low health literacy such as lower educational attainment, migration history and chronic illnesses overlap with those for long-term unemployment – in itself a risk factor for low health literacy. These factors are difficult to address in interventions to support health literacy. Therefore, the objective of this review is to identify potentially modifiable predictors of HL in populations potentially affected by long-term unemployment. Methods A rapid review (PROSPERO registration number: 290873) was carried out in Pubmed and SCOPUS including quantitative studies on potentially modifiable predictors of health literacy in working-age populations following PRISMA guidelines for systematic reviews. Where possible, reported effect sizes were transformed into r, and random-effects meta-analyses were conducted where appropriate to pool effect sizes for the association between modifiable predictors and health literacy. Results In total, 4765 titles and abstracts were screened, 114 articles were assessed in full-text screening, and 54 were included in the review. Forty-one effect sizes were considered for 9 different meta-analyses. Higher language proficiency, higher frequency of internet use, using the internet as a source of health information more often, being more physically active, more oral health behaviours, watching more health-related TV and a good health status were significantly associated with higher health literacy. Significant heterogeneity suggests between-study differences. Conclusions Improving language proficiency and/or providing information in multiple and simplified languages, together with reliable and accessible health information on the internet and in linear media are potentially promising targets to improve health literacy levels in working-age populations.

Assessment of health literacy in a French emergency department

“…Several sociodemographic factors that were described as associated with HL in previous studies were assessed herein [ 6 , 7 , 12 , 14 , 24 – 27 ]. It has been shown that the elderly, individuals with disabilities, those with lower socioeconomic status, ethnic minorities, and those with limited education had a lower HL level [ 28 ].…”

“…Sociodemographic variables collected were: age (categorized from 18-25 to >75 in 10-year intervals as used in the study reporting the development and validation of the HLS 19 -Q12 study [ 15 ]), sex (male or female), country of birth, native language), level of education (less than middle school, middle school, high school, more than high school), profession, perceived health status (very good, good, bad, very bad), internet access (yes or no), living environment (rural or urban), isolated (yes or no). These sociodemographic factors were chosen because they had already been reported to be associated with HL [ 6 , 7 , 12 , 14 , 24 – 27 ]. We added whether they were referred to the ED by a physician (either during a consultation or by telephone, including via the emergency telephone number for medical help; yes or no) could potentially been linked with HL level.…”

Gesundheitskompetenz (Health Literacy) und Compliance – Teil 1

“…Aus den WHO/EU-Datenauswertungen von 2021 wurden aus den einzelnen Health-Literacy-Kategorien jene Aufgaben selektiert, die als am schwierigsten zu bewältigen beschrieben wurden [12] [13].…”

“…Dafür sind Vorinformationen notwendig, um aus der Fülle an Auswahlmöglichkeiten seriöses Material selektieren zu können. Auch das ist schwierig, wenn die Landessprache nicht gut beherrscht wird [13].…”

Health Literacy of Caregivers

“…Studies of health literacy have revealed low rates: 36% in the United States (Kutner et al, 2006), 47.6% in the European Union (Sørensen et al, 2015), and 64.6% in Turkey (Durusu Tanrıöver et al, 2014). Research reports a significant relationship between health literacy level and older age, socioeconomic level, and education (Beauchamp et al, 2015; Schillinger, 2020; Singh et al, 2022; Yuen et al, 2018).…”