Health literacy and associated factors in patients with chronic diseases, Brazil

Abstract

Abstract Chronic diseases of the population have been a global challenge for public health. Considered a new field of study, health literacy (LS) is the ability to obtain and understand basic health information and services needed to make health decisions. Worse outcomes, such as less control of chronic diseases, have been associated with LS. Thus, the objective of the study was to investigate the association of LS, clinical and behavioral conditions in patients with chronic non-communicable diseases (NCDs) users of the public health service in Brazil. It was a cross-sectional study, conducted from July to December 2019, with 238 adult users of the public health service, in a random sample, from 10 basic health units, in Piracicaba-SP, Brazil. A questionnaire was applied to obtain socioeconomic, behavioral, and LS data (Suka et al, 2013). The outcome was LS (high, medium and low) and the independent variables: CNCDs (diabetes, systemic blood pressure), clinical conditions (pressure, tooth loss, pain, visible plaque and insertion loss), behaviors (brushing, use of dental floss), determinants (type and frequency of service use) and self-perception (oral health and quality of life) in health. Descriptive statistical analysis was performed, and the Chi-Square test, based on a conceptual model adapted for LS (5% significance level). They had low levels of literacy 35.3% (n = 84), average 35.7% (n = 85), and high 29.0% (n = 69). Low LS levels were associated with older individuals, low education, less brushing and flossing, irregular use of dental services, edentulism, pain, loss of insertion, negative self-perception of oral health and quality of life, and better systolic blood pressure index. The results of this study show the association of LS with behavioral and clinical factors, showing an important role in the health-disease process in this population. LS should be considered in health promotion policies in future studies. Key messages Our study shows the importance of health literacy, and its association with health outcomes in individuals with chronic non-communicable diseases. Within the important global epidemiological panorama of chronic diseases, better understanding the role of LS is important, and it can collaborate with health promotion strategies for this population.