Abstract
BackgroundRefugees have poorer health compared to indigenous populations, which may be explained by lower health literacy, i.e. not being able to access, understand, appraise or apply health information. This study aims to determine levels of functional and comprehensive health literacy, and factors associated with inadequate health literacy, in refugees coming to Sweden.MethodA cross-sectional study was performed among 455 adult refugees speaking Arabic, Dari, Somali or English. Participants in 16 strategically selected language schools for immigrants responded to a questionnaire. Health literacy was measured using the Swedish Functional Health Literacy Scale and the HLS-EU-Q16 questionnaire. Uni- and multivariate statistical methods were used to investigate group differences.ResultsThe majority of the participating refugees had inadequate or limited functional health literacy and comprehensive health literacy. About 60% of them had inadequate functional health literacy and 27% had inadequate comprehensive health literacy. Low education and/or being born in Somalia were factors associated with an increased risk of having inadequate functional health literacy. Having inadequate functional health literacy was associated with an increased risk of having inadequate comprehensive health literacy.ConclusionsThe majority of refugees in the language schools had limited or poor health literacy. Health literacy should be taken into consideration in contexts and in activities addressing migrants. More research is needed to better understand health literacy among refugees and to develop strategies and methods to increase health literacy and make life easier for those with low health literacy.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1030) contains supplementary material, which is available to authorized users.
Highlights
Refugees have poorer health compared to indigenous populations, which may be explained by lower health literacy, i.e. not being able to access, understand, appraise or apply health information
Low education and/or being born in Somalia were factors associated with an increased risk of having inadequate functional health literacy
Having inadequate functional health literacy was associated with an increased risk of having inadequate comprehensive health literacy
Summary
Refugees have poorer health compared to indigenous populations, which may be explained by lower health literacy, i.e. not being able to access, understand, appraise or apply health information. E.g. living conditions and access to healthcare and information [12], matter Some of those factors may in addition be affected by the refugee’s views and experiences of health and health care [5], which can differ from those in the recipient countries [13,14,15]. People in the recipient countries in the West often have more scientific views on health and health care and more often define problems as medical or psychological, compared to many refugees’ cultures, where the same issues might be seen as religious/moral or political/social [5,13]. The limited access to health care among refugees can in turn be caused by communication problems and a lack of knowledge about health and the health care system [5,7,8,17], which may be related to low health literacy (HL) [7,8]
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