Abstract
Health literacy (HL) is an important determinant of health. Sub-optimal HL can have profound consequences for individuals and health systems. However, little is known about the HL of older Singaporeans. This study determined the prevalence, socio-demographic and health-related correlates of limited and marginal HL among older Singaporeans (≥65 years). Data from a national survey were analysed (n=2327). HL was measured using the 4-item BRIEF with a 5-point response scale (range 4-20), and classified as limited, marginal, and adequate. Multinomial logistic regression models were applied to identify correlates of limited and marginal HL versus adequate HL. The weighted prevalence of limited HL was 42.0%, marginal HL was 20.4% and adequate HL was 37.7%. In adjusted regression analysis, older adults in advanced age groups with lower education and those living in 1-3 room flats had higher risk of limited HL. Furthermore, having ≥3 chronic diseases (Relative Risk Ratio [RRR]=1.70, 95% Confidence Interval [95% CI]=1.15, 2.52), poor self-rated health (RRR=2.07, 95% CI=1.56, 2.77), vision impairment (RRR=2.08, 95% CI=1.55, 2.80), hearing impairment (RRR=1.57, 95% CI=1.15, 2.14) and mild cognitive impairment (RRR=4.87, 95% CI=2.12, 11.19) were also associated with limited HL. The likelihood of marginal HL was higher among those with lower education, ≥2 chronic diseases, poor self-rated health (RRR=1.48, 95% CI=1.09, 2.00), vision impairment (RRR=1.45, 95% CI=1.06, 1.99) and hearing impairment (RRR=1.50, 95% CI=1.08, 2.08). Over two-thirds of older adults faced difficulties in reading, understanding, exchanging, and using health information and resources. There is a pressing need to create awareness about the issues that could result from the mismatch between healthcare system demands and the HL of older adults.
Published Version
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