Self-rated literacy level does not explain educational differences in health and disease

被引：5
作者：
Fransen M.P. [1 ]
Rowlands G. [2 ,3 ]
Leenaars K.E.F. [1 ]
Essink-Bot M.-L. [1 ]
机构：
[1] Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam
[2] Department of Primary Care and Public Health Sciences, King's College London, London
[3] Institut for Folkesundhed, Aarhus Universitet, Aarhus
来源：
Archives of Public Health | / 72卷 / 1期
关键词：
Educational inequalities; Health literacy; Literacy; Literacy measures; Long term condition; Self-rated health; Socio-economic inequalities;
D O I：
10.1186/2049-3258-72-14
中图分类号：
学科分类号：
摘要：
Background: Although literacy is increasingly considered to play a role in socioeconomic inequalities in health, its contribution to the explanation of educational differences in health has remained unexplored. The aim of this study was to investigate the contribution of self-rated literacy to educational differences in health. Methods: Data was collected from the Healthy Foundation and Lifestyle Segmentation Dataset (n = 4257). Selfrated literacy was estimated by individuals' self-reported confidence in reading written English. We used logistic regression analyses to assess the association between educational level and health (long term conditions and selfrated health). Self-rated literacy and other potential explanatory variables were separately added to each model. For each added variable we calculated the percentage change in odds ratio to assess the contribution to the explanation of educational differences in health. Results: People with lower educational attainment level were more likely to report a long term condition (OR 2.04, CI 1.80-2.32). These educational differences could mostly be explained by age (OR decreased by 27%) and could only minimally be explained by self-rated literacy, as measured by self-rated reading skills (OR decreased by 1%). Literacy could not explain differences in cardiovascular condition or diabetes, and only minimally contributed to mental health problems and depression (OR decreased by 5%). The odds of rating ones own health more negatively was higher for people with a low educational level compared to those with a higher educational level (OR 1.83, CI 1.59-2.010), selfrated literacy decreased the OR by 7%. Conclusion: Measuring self-rated reading skills does not contribute significantly to the explanation of educational differences in health and disease. Further research should aim for the development of objective generic and specific instruments to measure health literacy skills in the context of health care, disease prevention and health promotion. Such instruments are not only important in the explanation of educational differences in health and disease, but can also be used to identify a group at risk of poorer health through low basic skills, enabling health services and health information to be targeted at those with greater need. © 2014 Fransen et al.
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  • [1] De Vogli R., Brunner E., Marmot M.G., Unfairness and the social gradient of metabolic syndrome in the Whitehall II Study, J Psychosom Res, 63, 4, pp. 413-419, (2007)
  • [2] Singh-Manoux A., Nabi H., Shipley M., Gueguen A., Sabia S., Dugravot A., Marmot M., Kivimaki M., The role of conventional risk factors in explaining social inequalities in coronary heart disease: the relative and absolute approaches to risk, Epidemiology, 19, 4, pp. 599-605, (2008)
  • [3] Stansfeld S.A., Head J., Marmot M.G., Explaining social class differences in depression and well-being, Soc Psychiatry Psychiatr Epidemiol, 33, 1, pp. 1-9, (1998)
  • [4] Closing the gap in a generation: health equity through action on the social determinants of health, (2008)
  • [5] DeWalt D.A., Berkman N.D., Sheridan S., Lohr K.N., Pignone M.P., Literacy and health outcomes: a systematic review of the literature, J Gen Intern Med, 19, 12, pp. 1228-1239, (2004)
  • [6] DeWalt D.A., Hink A., Health literacy and child health outcomes: a systematic review of the literature, Pediatrics, 124, pp. S265-S274, (2009)
  • [7] Rothman R., Malone R., Bryant B., Dewalt D., Pignone M., Health literacy and diabetic control, JAMA, 288, 21, pp. 2687-2688, (2002)
  • [8] Rothman R., Malone R., Bryant B., Horlen C., Dewalt D., Pignone M., The relationship between literacy and glycemic control in a diabetes diseasemanagement program, Diabetes Educ, 30, 2, pp. 263-273, (2004)
  • [9] Rothman R.L., DeWalt D.A., Malone R., Bryant B., Shintani A., Crigler B., Weinberger M., Pignone M., Influence of patient literacy on the effectiveness of a primary care-based diabetes disease management program, JAMA, 292, 14, pp. 1711-1716, (2004)
  • [10] Schillinger D., Grumbach K., Piette J., Wang F., Osmond D., Daher C., Palacios J., Sullivan G.D., Association of health literacy with diabetes outcomes, JAMA, 288, 4, pp. 475-482, (2002)
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