Abstract
BackgroundA person’s health literacy determines whether they are able to make appropriate health decisions and are able to follow treatment instructions. This is important because low health literacy is associated with mortality and extra costs to the healthcare system. Our aim was to describe the health literacy levels of British adults using a nationally representative population survey, and show how health literacy levels vary by population characteristics.MethodsA population based cross-sectional survey including questions from two domains from the Health Literacy Questionnaire™: 1) Understanding health information well enough to know what to do, and 2) Ability to actively engage with health care providers. Both domains are made up of 5 Likert style questions with 5 levels ranging from ‘cannot do or always difficult’ (1) to ‘always easy’ (5). The survey was conducted by NatCen in Britain (2018) as part of the annual British Social Attitudes survey. We used weighted descriptive analyses and regression to explore the relationship between population characteristics and health literacy. Weighted analyses were used to ensure the sample was representative of the British population.ResultsA total of 2309 responded to the questionnaire. The mean score for ‘understanding information’ was 3.98 (95% CI: 3.94, 4.02) and for ‘ability to engage’ was 3.83 (95% CI: 3.80, 3.87), where 5 is the highest score. 19.4% had some level of difficulty reading and understanding written health information, and 23.2% discussing health concerns with health care providers. The adjusted logistic regression for ‘understanding information’ showed that those with lower health literacy were more likely to be in the most socially deprived quintile (OR 2.500 95% CI: 1.180, 5.296), have a limiting health condition or disability (OR 4.326 95% CI: 2.494, 7.704), and have no educational qualifications (OR 7.588 95% CI: 3.305, 17.422). This was similar for the ‘ability to engage’ domain.ConclusionsThis study described the distribution of health literacy levels for the British population in 2018. Interventions to improve health literacy will best be targeted at those with lower levels of education, those living in the most deprived areas, and those with a limiting health condition or disability.
Highlights
A person’s health literacy determines whether they are able to make appropriate health decisions and are able to follow treatment instructions
The Health Literacy QuestionnaireTM (HLQ) is a measure based on a person’s subjective assessment. It was developed and validated in Australia [8] and has been used to measure health literacy in different countries [13, 14]. It consists of nine domains of health literacy: feeling understood and supported by healthcare providers, having sufficient information to manage health, actively managing health, social support for health, appraisal of health information, ability to actively engage with healthcare providers, navigating the healthcare system, ability to find good health information, and understanding health information enough to know what to do [8]
91% of the respondents were white and weighting changed this to 85%, increasing the weight of Black Asian Minority Ethnic (BAME) people in the analysis
Summary
A person’s health literacy determines whether they are able to make appropriate health decisions and are able to follow treatment instructions This is important because low health literacy is associated with mortality and extra costs to the healthcare system. A person’s health literacy determines whether they are able to make appropriate health decisions and are able to follow treatment instructions [1, 2]. The Health Literacy QuestionnaireTM (HLQ) is a measure based on a person’s subjective assessment. It was developed and validated in Australia [8] and has been used to measure health literacy in different countries [13, 14]. It consists of nine domains of health literacy: feeling understood and supported by healthcare providers, having sufficient information to manage health, actively managing health, social support for health, appraisal of health information, ability to actively engage with healthcare providers, navigating the healthcare system, ability to find good health information, and understanding health information enough to know what to do [8]
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