Abstract
Background: Health literacy (HL) has been linked to empowerment, use of health services, and equity. Evaluating HL in people with cardiovascular health problems would facilitate the development of suitable health strategies care and reduce inequity. Aim: To investigate the relationship between different dimensions that make up HL and social determinants in patients with cardiovascular disease. Methods: Observational, descriptive, cross-sectional study in patients with cardiovascular disease, aged 50–85 years, accessing primary care services in Valencia (Spain) in 2018–2019. The Health Literacy Questionnaire was used. Results: 252 patients. Age was significantly related with the ability to participate with healthcare providers (p = 0.043), ability to find information (p = 0.022), and understanding information correctly to know what to do (p = 0.046). Level of education was significant for all HL dimensions. Patients without studies scored lower in all dimensions. The low- versus middle-class social relationship showed significant results in all dimensions. Conclusions: In patients with cardiovascular disease, level of education and social class were social determinants associated with HL scores. Whilst interventions at individual level might address some HL deficits, inequities in access to cardiovascular care and health outcomes would remain unjustly balanced unless structural determinants of HL are taken into account.
Highlights
Health literacy (HL) has been linked to empowerment, use of health services, and equity
We focused on 6 areas within the Xàtiva/Ontinyent Health Department (Valencia, Spain) selected at random from the 17 areas that make up the department
We assessed the social determinants that make up the axes of inequality and their involvement in HL to clarify whether measuring HL would facilitate addressing health inequalities and increase health equity
Summary
Health literacy (HL) has been linked to empowerment, use of health services, and equity. Evaluating HL in people with cardiovascular health problems would facilitate the development of suitable health strategies care and reduce inequity. Aim: To investigate the relationship between different dimensions that make up HL and social determinants in patients with cardiovascular disease. Methods: Observational, descriptive, cross-sectional study in patients with cardiovascular disease, aged 50–85 years, accessing primary care services in Valencia (Spain) in 2018–2019. The unequal distribution of social determinants results in unfair, systematic, and avoidable health inequalities between socially, economically, demographically, or geographically defined population groups. Inequalities in health are the result of the unequal distribution of power and resources according to gender, social class, territory, or ethnicity, producing a worse state of health in the less socially advantaged citizens [2]. In Spain, the Commission for Reducing Health Inequalities developed a model based on Navarro and Solar and Irwin for the.
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