The Relationship between Health Literacy, Quality of Life, and Subjective Health: Results of a Cross-Sectional Study in a Rural Region in Germany

Abstract

Low health literacy is associated with poorer health and quality of life. An open question is whether a regional integrated healthcare system whose management strives to enable and empower its members with regard to health issues can contribute to a higher level of health literacy in the population. Against this background, in a cross-sectional study we surveyed a random selection of members of an integrated healthcare system in southwestern Germany (n = 180). The standardized questionnaire included, inter alia, questions on health literacy and subjective health. In this sample we wanted to (1) determine the proportion of respondents with sufficient health literacy and (2) investigate whether the association between health literacy and quality of life and subjective health status—as found in other studies—can be replicated. In our sample a health literacy score could be calculated in 126 subjects (70%). A sufficient level of health literacy was detected in 62% of respondents. Confirming the findings of a meta-analysis based on international studies, we found moderate correlations between health literacy and quality of life (r = 0.41) and health literacy and subjective health status (r = 0.40); these correlations hardly decreased when we controlled for various sociodemographic characteristics. As the proportion of respondents with sufficient health literacy was higher in our sample than in comparable studies conducted in Germany, we may hypothesize that an integrated healthcare system like the one we surveyed could have contributed to increased health literacy in the population. Thus, it could be worthwhile to investigate this research question with a more rigorous study design and a larger sample.

Measuring Health Literacy in Southern Italy: A cross-sectional study

“…Multivariate analysis showed that only the education level was associated with HL among the three sociodemographic characteristics. This is consistent with other studies [2,4,5,10,20,[49][50][51][52][53] and the World Health Organisation's statement that consider people with low level of education as a vulnerable group with a scarce HL [2].…”

“…Health behaviour measured by GSE and health status measured by EQ-VAS were positively correlated with HL as expected [2,53,54].…”

Health literacy, health perception and related factors among different ethnic groups: a cross-sectional study in southeastern Turkey

“…The results of many studies conducted among adult individuals in different countries have shown that those more likely to have low HL levels are older adults, unemployed people, individuals with low educational and low-income levels [ 37 – 39 ]. Furthermore, it has been revealed that those who evaluate their own health as bad also have a low level of HL [ 5 , 36 , 40 ]. These findings, indicating that some social groups have low levels of HL, seem to show that there are various social factors involved in HL.…”

Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19

“…In "Inclusion of People with Intellectual Disabilities in Health Literacy", Latteck and Bruland [85] present findings from three different studies on the health literacy of particular vulnerable groups. Ehmann et al [86] give information to guide future work in "The Relationship between Health Literacy, Quality of Life, and Subjective Health: Results of a Cross-Sectional Study in a Rural Region in Germany", which will be of particular relevance to a regional integrated healthcare system. Sykes et al [87] give insights on health literacy on the topic of infertility in "Multidimensional eHealth Literacy for Infertility", considering the concept of eHealth literacy in individuals and couples in relation to infertility.…”