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

Author

Listed:
  • 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
    UCD Geary Institute for Public Policy, University College Dublin, Dublin 4, D04 V1W8, Ireland)

  • Gillian Rowlands

    (Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK)

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.

Suggested Citation

  • Sarah Gibney & Lucy Bruton & Catherine Ryan & Gerardine Doyle & Gillian Rowlands, 2020. "Increasing Health Literacy May Reduce Health Inequalities: Evidence from a National Population Survey in Ireland," IJERPH, MDPI, vol. 17(16), pages 1-17, August.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:16:p:5891-:d:398702
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    References listed on IDEAS

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    1. Asaria, Miqdad & Doran, Tim & Cookson, Richard, 2016. "The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation," LSE Research Online Documents on Economics 101244, London School of Economics and Political Science, LSE Library.
    2. Burke, Sara Ann & Normand, Charles & Barry, Sarah & Thomas, Steve, 2016. "From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis," Health Policy, Elsevier, vol. 120(3), pages 235-240.
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    2. Andreia Costa & Rodrigo Feteira-Santos & Violeta Alarcão & Adriana Henriques & Teresa Madeira & Ana Virgolino & Miguel Arriaga & Paulo J. Nogueira, 2023. "Health Literacy among Older Adults in Portugal and Associated Sociodemographic, Health and Healthcare-Related Factors," IJERPH, MDPI, vol. 20(5), pages 1-16, February.
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