Abstract
Health literacy is a key determinant of the public health and health climate of the nation. This study examined the functional health literacy of the nation, factors associated with health literacy, and its relationship with diabetes recognition. This cross-sectional survey recruited participants (N = 2895) who were 18 years and above from a population registry through disproportionate stratified sampling. The Brief Health Literacy Screen and other questionnaires were administered through face-to-face interviews, in one of the four national languages (English, Chinese, Malay or Tamil). The majority (80.5%) had adequate functional health literacy and were able to recognise symptoms of diabetes correctly (83.5% overall; 83.7% and 82.2% in those with adequate and inadequate health literacy, respectively). Those with inadequate health literacy had a higher incidence of chronic conditions (p < 0.001) compared to those with adequate health literacy in bivariate analysis. The majority of the sample had sufficient levels of physical activity (83.3%), and more than half reported an unhealthy lifestyle (57.4%). Older age, Chinese ethnicity, those who were employed, with lower education (secondary or below), and were married had significantly higher odds of inadequate health literacy. Health literacy was not associated with lifestyle, physical activity, chronic conditions and diabetes recognition. Health literacy interventions should focus on the disadvantaged social groups for improving their health literacy.
Highlights
This study examined the (a) HL of the general public, (b) factors associated with HL, and (c) association of HL with diabetes recognition, lifestyle and Physical activity (PA)
Disproportionate sampling ensured that the multi-ethnic population and different age groups were well-represented in the final sample and survey weights were applied, making this sample representative of the actual population
The participants in this study had a mean age of 45.8 (±16.9) years, 51.6% were females, 75.8% were of Chinese ethnicity, 40.7% had an education status of secondary or below, 61.7% were married and 70.5% were employed (Table 1)
Summary
Licensee MDPI, Basel, Switzerland.Attribution (CC BY) license (https://creativecommons.org/licenses/by/ 4.0/).Health literacy (HL) refers to the cognitive and social skills that equip an individual to receive, analyse and understand health information in order to make appropriate health care decisions and lifestyle choices [1]. The skills related to HL are grouped under three main categories of functional (basic numeracy, skills to read, write and gather health-related information in health care milieu), interactive (higher cognitive skills to gather, comprehend and apply necessary information to changing contexts to make effective decisions), and critical HL (skills to analyse and make use of the information to improve health) [2,3].Int. J. Environ. Res. Public Health 2021, 18, 9316. https://doi.org/10.3390/ijerph18179316 https://www.mdpi.com/journal/ijerph
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