Increasing Health Literacy May Reduce Health Inequalities: Evidence from a National Population Survey in Ireland

Sarah Gibney, Lucy Bruton, Catherine Ryan, Gerardine Doyle and Gillian Rowlands
Additional contact information
Sarah Gibney: Department of Health, Dublin 2, DO2 XW14, Ireland
Lucy Bruton: Department of Health, Dublin 2, DO2 XW14, Ireland
Catherine Ryan: Department of Health, Dublin 2, DO2 XW14, Ireland
Gerardine Doyle: UCD College of Business, University College Dublin, Dublin 4, D04 V1W8, Ireland
Gillian Rowlands: Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK

IJERPH, 2020, vol. 17, issue 16, 1-17

Abstract: Background . Health literacy has been separately associated with socio-economic status and worse health status and outcomes. However, the magnitude of the associations between health literacy and health status and outcomes may not be evenly distributed across society. This study aims to estimate and compare the associations between health status, health behaviours, and healthcare utilisation within different levels of social status in the Irish population. Materials and methods . Data from Ireland collected as part of the 2011 European Health Literacy Survey were analysed. General health literacy was measured on a 0–50 scale, low to high. There were four binary outcomes: long-standing health conditions, smoking, hospital visits in the last 12 months, and self-rated health status. Logistic regression analysis was conducted to estimate the likelihood of each health outcome. Health literacy was treated as the main independent variable. Marginal effects were calculated using the delta method to demonstrate the change in likelihood of each outcome associated with a 5-point increase in health literacy score. The sample was grouped into tertiles based on self-reported social status, and models were replicated and compared for each tertile. Models were adjusted for known correlates of health literacy and health: age, gender, and education. Analysis was conducted using Stata V14. Results . Higher health literacy scores were associated with a lower probability of having a limiting illness within the low social status group only. Higher health literacy scores were associated with a lower probability of three or more hospital visits in the past 12 months in the low and middle social status groups. For people in the low and middle social status groups, higher health literacy levels were associated with a lower probability of being a current smoker. The associations between health literacy and self-rated health status were similar in each social status group. Conclusions : Improvement in population health literacy may reduce the prevalence of long-term chronic health conditions, reduce smoking levels, and result in fewer hospital visits. Whilst improved health literacy should improve behaviours and outcomes in all groups, it should have a more marked impact in lower social status groups, and hence contribute to reducing the observed social disparities in these health outcomes.

Keywords: health literacy; health inequalities; health disparities; reduction of inequalities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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