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Low Health Literacy and Mortality in Individuals with Cardiovascular Disease, Chronic Obstructive Pulmonary Disease, Diabetes, and Mental Illness: A 6-Year Population-Based Follow-Up Study

Author

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  • Karina Friis

    (DEFACTUM, Central Denmark Region, 8200 Aarhus, Denmark)

  • Anna Aaby

    (Department of Public Health, Section for Health Promotion and Health Services, Aarhus University, 8000 Aarhus, Denmark)

  • Mathias Lasgaard

    (DEFACTUM, Central Denmark Region, 8200 Aarhus, Denmark)

  • Marie Hauge Pedersen

    (DEFACTUM, Central Denmark Region, 8200 Aarhus, Denmark)

  • Richard H. Osborne

    (Centre for Global Health and Equity, Swinburne University of Technology, Melbourne 3025, Australia)

  • Helle Terkildsen Maindal

    (Department of Public Health, Section for Health Promotion and Health Services, Aarhus University, 8000 Aarhus, Denmark
    Health Promotion, Steno Diabetes Centre Copenhagen, 2820 Gentofte, Denmark)

Abstract

Background: The objective of the study was to examine the impact of health literacy on mortality in the general population and among individuals with cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), diabetes, and mental illness. Methods: Data from a large Danish health survey ( n = 29,473) from 2013 were linked with national mortality registry data to permit a 6-year follow-up. Results: Individuals reporting difficulties in understanding information about health, had higher risk of dying during follow-up (hazard rate (HR) 1.38 (95% CI 1.11–1.73)) compared with those without difficulties. Higher risk was also observed among people reporting CVD (HR 1.47 (95% CI 1.01–2.14)), diabetes (HR 1.91 (95% CI 1.13–3.22)) and mental illness (HR 2.18 (95% CI 1.25–3.81)), but not for individuals with COPD. Difficulties in actively engaging with healthcare providers was not associated with an increase in the risk of dying in the general population or in any of the four long-term condition groups. Conclusions: Aspects of health literacy predict a higher risk of dying during a 6-year follow-up period. Our study serves as a reminder to healthcare organizations to consider the health literacy responsiveness of their services in relation to diverse health literacy challenges and needs.

Suggested Citation

  • Karina Friis & Anna Aaby & Mathias Lasgaard & Marie Hauge Pedersen & Richard H. Osborne & Helle Terkildsen Maindal, 2020. "Low Health Literacy and Mortality in Individuals with Cardiovascular Disease, Chronic Obstructive Pulmonary Disease, Diabetes, and Mental Illness: A 6-Year Population-Based Follow-Up Study," IJERPH, MDPI, vol. 17(24), pages 1-10, December.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:24:p:9399-:d:462447
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    1. Jonathan O’Hara & Crystal McPhee & Sarity Dodson & Annie Cooper & Carol Wildey & Melanie Hawkins & Alexandra Fulton & Vicki Pridmore & Victoria Cuevas & Mathew Scanlon & Patricia M. Livingston & Richa, 2018. "Barriers to Breast Cancer Screening among Diverse Cultural Groups in Melbourne, Australia," IJERPH, MDPI, vol. 15(8), pages 1-13, August.
    2. Mackenbach, Johan P., 2012. "The persistence of health inequalities in modern welfare states: The explanation of a paradox," Social Science & Medicine, Elsevier, vol. 75(4), pages 761-769.
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    Cited by:

    1. Stinne Eika Rasmussen & Anna Aaby & Anne Søjbjerg & Anna Mygind & Helle Terkildsen Maindal & Olli Paakkari & Kaj Sparle Christensen, 2023. "The Brief Health Literacy Scale for Adults: Adaptation and Validation of the Health Literacy for School-Aged Children Questionnaire," IJERPH, MDPI, vol. 20(22), pages 1-13, November.
    2. Meehoh Kim & David Suh & Joseph A. Barone & Sun-Young Jung & Wenchen Wu & Dong-Churl Suh, 2022. "Health Literacy Level and Comprehension of Prescription and Nonprescription Drug Information," IJERPH, MDPI, vol. 19(11), pages 1-14, May.
    3. Shyam Sundar Budhathoki & Melanie Hawkins & Gerald Elsworth & Michael T. Fahey & Jeevan Thapa & Sandeepa Karki & Lila Bahadur Basnet & Paras K. Pokharel & Richard H. Osborne, 2022. "Use of the English Health Literacy Questionnaire (HLQ) with Health Science University Students in Nepal: A Validity Testing Study," IJERPH, MDPI, vol. 19(6), pages 1-14, March.

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