BackgroundHealth literacy is of increasing importance in public health research. It is a necessary pre-condition for the involvement in decisions about health and health care and related to health outcomes. Knowledge about limited health literacy in different age groups is crucial to better target public health interventions for subgroups of the population. However, little is known about health literacy in Germany. The study therefore assesses the prevalence of limited health literacy and associated factors among different age groups.MethodsThe Health Literacy Survey Germany is a cross-sectional study with 2,000 participants aged 15 years or older in private households. Perceived health literacy was assessed via computer-assisted personal interviews using the HLS-EU-Q-47 questionnaire. Descriptive analyses, chi-square tests and odds ratios were performed stratified for different age groups.ResultsThe population affected by limited perceived health literacy increases by age. Of the respondents aged 15–29 years, 47.3 % had limited perceived health literacy and 47.2 % of those aged 30–45 years, whereas 55.2 % of the respondents aged 46–64 years and 66.4 % aged 65 years and older showed limited perceived health literacy. In all age groups, limited perceived health literacy was associated with limited functional health literacy, low social status, and a high frequency of doctor visits.ConclusionsThe results suggest a need to further investigate perceived health literacy in all phases of the life-course. Particular attention should be devoted to persons with lower social status, limited functional health literacy and/or a high number of doctor visits in all age groups.
The low health literacy of many Germans can impair communication between doctors and patients and exacerbate existing problems in health policy. In the future, greater effort will have to be made to foster health literacy, make health-related information for patients easier to understand, and intensify research in the field of health literacy.
Zusammenfassung Ziel Durch die Digitalisierung gewinnen digitale Informationen zum Thema Gesundheit zunehmend an Bedeutung. Neben vielfältigen Chancen bringt diese Entwicklung auch Herausforderungen mit sich, denn mit dem wachsenden Angebot steigt zugleich der Bedarf an digitaler Gesundheitskompetenz (DGK). Im nachfolgenden Beitrag werden das Ausmaß der DGK in der Bevölkerung in Deutschland, zentrale Determinanten der DGK und Folgen für die Nutzung digitaler gesundheitsbezogener Informationsangebote analysiert. Methodik Die Analyse basiert auf Daten des zweiten Health Literacy Survey Germany (HLS-GER 2), bestehend aus einer repräsentativen Stichprobe mit n=2151. Die Erfassung der DGK, der Determinanten sowie der Nutzung digitaler gesundheitsbezogener Informationsangebote erfolgte mit einem im Rahmen der internationalen Vergleichsstudie HLS19 erarbeiteten Fragebogens. Es wurden bivariate und multivariate Analysen durchgeführt. Ergebnisse Insgesamt verfügen 75,8% der Bevölkerung über eine geringe DGK. Vor allem geringe literale Fähigkeiten, ein höheres Alter, eine niedrige Bildung sowie ein niedriger Sozialstatus gehen mit einer geringen DGK einher. Die multivariate Analyse weist zudem auf einen starken Zusammenhang zwischen DGK und allgemeiner Gesundheitskompetenz (GK) hin. Geringe DGK ist folgenreich und führt zu einer geringeren Nutzung digitaler gesundheitsbezogener Informationsangebote. Schlussfolgerung Die Ergebnisse unterstreichen die Wichtigkeit der Förderung von DGK der Bevölkerung und besonders von Gruppen mit geringer DGK. Entsprechende Bemühungen sollten die allgemeine GK einbeziehen, denn sie steht in engem Zusammenhang mit der DGK. Auch um die noch geringe Nutzung digitaler Informationsangebote in Deutschland zu erhöhen und generell, um der zunehmenden Digitalisierung des Gesundheitswesens zu entsprechen, stellt die Stärkung der DGK eine gesellschaftlich wichtige Aufgabe dar.
Health literacy is especially important for older people to maintain or enhance remaining health resources and self-management skills. The aim of the study was to determine the level of health literacy and the association between health literacy, demographic and socio-economic factors in German older adults aged 65 years and above stratified by age group. Health literacy was assessed via computer-assisted personal interviews using HLS-EU-Q47 on a representative sample of the German-speaking population. Descriptive statistics, bivariate analyses and logistic regression modelling stratified by age group were conducted to assess health literacy of 475 respondents aged 65 years and above. Overall, 66.3% of all respondents aged 65 years and above had limited health literacy. Limited health literacy was especially prevalent among respondents above 76 years of age (80.6%). Limited health literacy was associated with financial deprivation (OR: 3.05; 95% CI: 1.99-4.67) and limited functional health literacy (OR: 2.16; 95% CI: 1.29-3.61). Financial deprivation was strongest predictor for limited health literacy in the total sample and stratified by age group. Limited health literacy is a frequent phenomenon in German adults aged 65 years and above. Research on health literacy in old age and the role in health disparities is urgently needed.
Zusammenfassung Die erste repräsentative Studie zur Gesundheitskompetenz in Deutschland (HLS-GER) zeigt, dass über die Hälfte der Bevölkerung über eine eingeschränkte Gesundheitskompetenz verfügt. Deshalb wird ein Nationaler Aktionsplan erarbeitet, dessen Ziel es ist, ein systematisches Programm zur Förderung der Gesundheitskompetenz zu entwickeln, die gesellschaftliche und politische Diskussion des Themas zu intensivieren, Handlungsbereitschaft auf unterschiedlichen Ebenen zu erzeugen und Veränderungen anzuregen.
ZusammenfassungIn den letzten Jahren sind in vielen Ländern Studien zur Gesundheitskompetenz der Bevölkerung erschienen. Fast immer zeigen sie, dass die Gesundheitskompetenz schlechter ausfällt als angenommen und große Teile der Bevölkerung eine niedrige Gesundheitskompetenz aufweisen. Um diese Situation zu verbessern, sind in vielen Ländern nationale Strategien und Aktionspläne zur Förderung von Gesundheitskompetenz erstellt worden. Diesen Beispielen folgend wurde jüngst auch für Deutschland ein Nationaler Aktionsplan Gesundheitskompetenz erarbeitet. An dem 2-jährigen Entwicklungsprozess waren 15 ausgewiesene Expertinnen und Experten beteiligt. Auf Basis einer Analyse vorliegender Literatur zur Gesundheitskompetenz und bestehender Aktionspläne wurden die Konzeption, Ziele und Schwerpunkte des Aktionsplans festgelegt und konkrete Empfehlungen erarbeitet. Der Nationale Aktionsplan Gesundheitskompetenz konzentriert sich auf die Handlungsbereiche alltägliche Lebenswelten, Gesundheitssystem, chronische Erkrankung und Forschung und formuliert für jeden konkrete Empfehlungen.
Background: Health literacy (HL) is defined as the ability to process health-related information to make decisions to maintain health and improve quality of life. A growing number of studies demonstrate that people with lower HL are less likely to use preventive services but more likely to use curative, emergency, or hospital care. Objective: This study investigated the relationship between HL and the use of different types of health services in a sample of the general German population, as we expected that the effect of HL on the frequency of use differs by type of health service. Methods: A nationally representative sample of 2,000 people in Germany was interviewed in person in 2014. Analyses of the data included frequencies of contacts with doctors, other health professionals, hospitals, and emergency services. Analysis also included a HL measure (European Health Literacy Survey Questionnaire), as well as sociodemographic and health status indicators. To test whether and how HL is related to the frequency of use of the different types of curative health services, regression analyses were performed. Key Results: Respondents with lower HL scores reported more frequent use of all four included types of curative health services. Although multiple regression analysis showed a direct significant effect of HL only on doctor (β = −.066) and other health professionals visits (β = −.103), no significant direct effect of HL on hospital and emergency services use was found when sociodemographic and health-related factors were controlled for. Conclusions: Health professionals should be aware that their patients are likely to have difficulties in understanding and processing health-related information. Interventions to strengthen HL should aim at improving health care literacy and, moreover, not only address individuals but also consider demands related to the health care system and health professionals' communication skills. Plain Language Summary: This study investigates the relationship between health literacy and health service use in Germany. The results show that health services are used more often by individuals with low health literacy. Thus, health professionals need to take low health literacy into account in their communication with patients. [ HLRP: Health Literacy Research and Practice. 2018;2(2):e115–e122.]
It is concluded that health literacy is linked to health behaviour and that unequal distributions of health literacy among young people may increase health inequalities.
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