Abstract

Health literacy has been identified as an important and changeable intermediary determinant of health equity. Vocational education and training (VET) schools are a relevant setting for health behavior interventions seeking to diminish health inequities because many VET students come from low socio-economic status backgrounds. This study examines VET students’ health literacy and its association with health behavior based on a cross-sectional survey among 6119 students from 58 VET schools in Denmark in 2019. Two scales from the Health Literacy Questionnaire was used to assess domains of health literacy. Data were analyzed using Anova and logistic regression. The study population consisted of 43.4% female, and mean age was 24.2 years (range 15.8–64.0). The health literacy domain ‘Actively managing my health’ mean was 2.51, SD 0.66, and ‘Appraisal of health information’ mean was 2.37, SD 0.65. For both domains, being female, older age, attending the VET educational program Care-health-pedagogy, and higher self-rated health were associated with higher scale scores. In the adjusted analyses, lower scale scores were associated with less frequent breakfast, daily smoking, high-risk alcohol behavior and moderate-to-low physical activity. Our results show that low health literacy is associated with unhealthy behaviors in this population. Our results support and inform health literacy research and practice in educational institutions and services.

Highlights

  • Health behavior among adolescents and young adults affects life expectancy as well as health and wellbeing throughout the life course [1]

  • A total of 6119 students participated, which corresponds to 5.9% of all students enrolled at Vocational education and training (VET) schools in Denmark

  • These results indicate that health literacy may be an important determinant of health behaviors in this population

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Summary

Introduction

Health behavior among adolescents and young adults affects life expectancy as well as health and wellbeing throughout the life course [1]. Exploring predictors and modifiers of youth health behavior is a crucial step towards effective early prevention of poor health outcomes. Low socio-economic status (SES) has been identified as such a predictor [2,3], and one possible mediating factor is health literacy [4,5,6]. Health literacy can be defined as “the combination of personal competencies and situational resources needed for people to access, understand, appraise and use information and services to make decisions about health. It includes the capacity to communicate, assert and act upon these decisions” [7]. The concept of health literacy constitutes individual competencies and capacities but is exercised in a dynamic interplay with available resources [8]

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