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The Relationship between Health Literacy and Health Disparities: A Systematic Review

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  • Sarah Mantwill
  • Silvia Monestel-Umaña
  • Peter J Schulz

Abstract

Objectives: Health literacy is commonly associated with many of the antecedents of health disparities. Yet the precise nature of the relationship between health literacy and disparities remains unclear. A systematic review was conducted to better understand in how far the relationship between health literacy and health disparities has been systematically studied and which potential relationships and pathways have been identified. Methods: Five databases, including PubMed/MEDLINE and CINAHL, were searched for peer-reviewed studies. Publications were included in the review when they (1) included a valid measure of health literacy, (2) explicitly conceived a health disparity as related to a social disparity, such as race/ethnicity or education and (3) when results were presented by comparing two or more groups afflicted by a social disparity investigating the effect of health literacy on health outcomes. Two reviewers evaluated each study for inclusion and abstracted relevant information. Findings were ordered according to the disparities identified and the role of health literacy in explaining them. Results: 36 studies were included in the final synthesis. Most of the studies investigated racial/ethnic disparities, followed by some few studies that systematically investigated educational disparities. Some evidence was found on the mediating function of health literacy on self-rated health status across racial/ethnic and educational disparities, as well as on the potential effect of health literacy and numeracy on reducing racial/ethnic disparities in medication adherence and understanding of medication intake. Conclusion: Overall the evidence on the relationship between health literacy and disparities is still mixed and fairly limited. Studies largely varied with regard to health(-related) outcomes under investigation and the health literacy assessments used. Further, many studies lacked a specific description of the nature of the disparity that was explored and a clear account of possible pathways tested.

Suggested Citation

  • Sarah Mantwill & Silvia Monestel-Umaña & Peter J Schulz, 2015. "The Relationship between Health Literacy and Health Disparities: A Systematic Review," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-22, December.
    • Handle: RePEc:plo:pone00:0145455
    DOI: 10.1371/journal.pone.0145455
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    References listed on IDEAS

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    1. Lopez, Claude & Kim, Bumyang & Sacks, Katherine, 2022. "Health Literacy in the United States: Enhancing Assessments and Reducing Disparities," MPRA Paper 114019, University Library of Munich, Germany.
    2. Alexandra Strassmann & Marco Kaufmann & Holger Dressel & Alexander Turk & Martin Röösli & Kees Hoogh & Steven S. Sadhra & Matthias Bopp & Milo A. Puhan, 2020. "Occupational exposure and the risk of airway obstruction and mortality," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(6), pages 823-833, July.
    3. Alexandra Strassmann & Marco Kaufmann & Holger Dressel & Alexander Turk & Martin Röösli & Kees Hoogh & Steven S. Sadhra & Matthias Bopp & Milo A. Puhan, 0. "Occupational exposure and the risk of airway obstruction and mortality," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 0, pages 1-11.
    4. Allen Suzane França & Catherine M. Pirkle & Tetine Sentell & Maria P. Velez & Marlos R. Domingues & Diego G. Bassani & Saionara M. A. Câmara, 2020. "Evaluating Health Literacy among Adolescent and Young Adult Pregnant Women from a Low-Income Area of Northeast Brazil," IJERPH, MDPI, vol. 17(23), pages 1-15, November.
    5. Adina Abdullah & Su May Liew & Hani Salim & Chirk Jenn Ng & Karuthan Chinna, 2019. "Prevalence of limited health literacy among patients with type 2 diabetes mellitus: A systematic review," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-16, May.
    6. Veronica Velasco & Andrea Gragnano & Gruppo Regionale HBSC Lombardia 2018 & Luca Piero Vecchio, 2021. "Health Literacy Levels among Italian Students: Monitoring and Promotion at School," IJERPH, MDPI, vol. 18(19), pages 1-13, September.
    7. Vieri Lastrucci & Chiara Lorini & Saverio Caini & Florence Health Literacy Research Group & Guglielmo Bonaccorsi, 2019. "Health literacy as a mediator of the relationship between socioeconomic status and health: A cross-sectional study in a population-based sample in Florence," PLOS ONE, Public Library of Science, vol. 14(12), pages 1-14, December.
    8. Fabiana A. Brito & Jamie M. Zoellner & Jennie Hill & Wen You & Ramine Alexander & Xiaolu Hou & Paul A. Estabrooks, 2019. "From Bright Bodies to iChoose: Using a CBPR Approach to Develop Childhood Obesity Intervention Materials for Rural Virginia," SAGE Open, , vol. 9(1), pages 21582440198, March.

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