Declines in health literacy and health-related quality of life during the COVID-19 pandemic: a longitudinal study of the Japanese general population

Hirono Ishikawa,Takahiro Kiuchi,Mio Kato

doi:10.1186/s12889-021-12092-x

Hirono Ishikawa, Takahiro Kiuchi + Show 1 more

Open Access

https://doi.org/10.1186/s12889-021-12092-x

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Abstract

BackgroundDuring the coronavirus disease 2019 (COVID-19) pandemic, the importance of health literacy (HL) was addressed by public health researchers. We longitudinally examined the changes in general HL and health-related quality of life (HRQOL) between immediately before the COVID-19 outbreak and 1 year later, and how general HL before the outbreak was related to changes in HRQOL in the Japanese general population.MethodsAmong the Japanese residents aged 20–79 years who participated in our previous study in 2017, 826 were followed-up via self-administered questionnaires in January 2020 and February 2021, for the purposes of this study. The HRQOL was measured using the SF-8, a short version of the SF-36 Health Survey, and general HL was measured using the short form of the European Health Literacy Survey Questionnaire (HL-SF12) in the 2020 and 2021 surveys.ResultsThe physical and mental dimensions of HRQOL as well as general HL declined significantly from immediately before the COVID-19 outbreak to 1 year later (p = .010, p < .001 and p < .001, respectively). The decline in HRQOL, especially the mental dimension, was more significant among women. A lower economic status was also related to a greater decline in HRQOL (p = .026 for the physical dimension and p = .012 for the mental dimension). Higher general HL before the COVID-19 outbreak was associated with a lesser decline in HRQOL in both the physical and mental dimensions (p = .040 and p < .001, respectively) after controlling for possible confounding variables such as gender and economic status.ConclusionsHealthcare support is crucial for vulnerable populations during and after the pandemic. General HL may be important for attenuating the decline in HRQOL, by enabling effective use of health information and adaptive behaviors toward health threats. Further studies are needed to better understand the association between HL and HRQOL.

Highlights

During the coronavirus disease 2019 (COVID-19) pandemic, the importance of health literacy (HL) was addressed by public health researchers
We longitudinally examined the changes in health-related quality of life (HRQOL) and general HL between 2020 and 2021 (1 year later) and how general HL before the outbreak was related to changes in HRQOL in the Japanese general population
This study longitudinally examined the changes in HRQOL and general HL between immediately before the COVID-19 outbreak and 1 year later, and how HL before the outbreak was related to changes in HRQOL in the Japanese general population

Summary

Introduction

During the coronavirus disease 2019 (COVID-19) pandemic, the importance of health literacy (HL) was addressed by public health researchers. Since the outbreak of coronavirus disease 2019 (COVID19), many countries have experienced large-scale societal changes that have had a profound impact on everyday life and behaviors. Governments have introduced substantial restrictions on people’s movements, including stay-at-home orders, limitations on gatherings, and the closure of non-essential workplaces. This was crucial for preventing the spread of COVID-19, such restrictions have led to severe economic downturns and job insecurity [1], which in turn had negative impacts on health and health-related behaviors. Declines in health-related quality of life (HRQOL) from before to during the pandemic have been reported among adolescents [9] and cancer patients [10]. COVID-19 directly affected health and indirectly impacted HRQOL by mandating changes in social norms and daily life

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