Abstract
BackgroundLow health literacy is considered a worldwide health threat. The purpose of this study is to assess the prevalence and socio-demographic covariates of low health literacy in Taiwanese adults and to investigate the relationships between health literacy and health status and health care utilization.MethodsA national survey of 1493 adults was conducted in 2008. Health literacy was measured using the Mandarin Health Literacy Scale. Health status was measured based on self-rated physical and mental health. Health care utilization was measured based on self-reported outpatient clinic visits, emergency room visits, and hospitalizations.ResultsApproximately thirty percent of adults were found to have low (inadequate or marginal) health literacy. They tended to be older, have fewer years of schooling, lower household income, and reside in less populated areas. Inadequate health literacy was associated with poorer mental health (OR, 0.57; 95% CI, 0.35-0.91). No association was found between health literacy and health care utilization even after adjusting for other covariates.ConclusionsLow (inadequate and marginal) health literacy is prevalent in Taiwan. High prevalence of low health literacy is not necessarily indicative of the need for interventions. Systematic efforts to evaluate the impact of low health literacy on health outcomes in other countries would help to illuminate features of health care delivery and financing systems that may mitigate the adverse health effects of low health literacy.
Highlights
IntroductionThe purpose of this study is to assess the prevalence and socio-demographic covariates of low health literacy in Taiwanese adults and to investigate the relationships between health literacy and health status and health care utilization
Low health literacy is considered a worldwide health threat
Three hundred and thirteen respondents (21.0%) did not report household income; 22.9% of respondents were in households that earned less than 50% of the national average household income in 2007, 16.9% earned 51-75% of the average, 12.5% earned 76-100% of the average, and 26.3% earned more than 100% of the average
Summary
The purpose of this study is to assess the prevalence and socio-demographic covariates of low health literacy in Taiwanese adults and to investigate the relationships between health literacy and health status and health care utilization. We report the results of a national assessment of health literacy in Taiwanese adults. The purpose is twofold: (1) to assess the prevalence and distribution of low health literacy in Taiwanese adults, and (2) to examine the associations of low health literacy with self-rated physical and mental health status and health care utilization (outpatient clinic visits, hospitalization, and emergency room visits). The results would help to confirm if low health literacy is a worldwide health threat, even in a country where the literacy rate is 97.8% and where 22.48% of the adult population has a university degree [17]. The system has expanded access by waiving copayments for the very poor, veterans, and aboriginal populations [18]
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