The relationship between health literacy and health outcomes among male young adults: exploring confounding effects using decomposition analysis.

Rüegg, René; Abel, Thomas (2019). The relationship between health literacy and health outcomes among male young adults: exploring confounding effects using decomposition analysis. International journal of public health, 64(4), pp. 535-545. Springer 10.1007/s00038-019-01236-x

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OBJECTIVES Previous studies indicate substantial correlations between low health literacy and poor health outcomes. However, empirical findings remain inconsistent and are theoretically challenging. In this study, we conceptually place health literacy within an established model of health inequality. Studying multiple pathways, we estimate the associations between health literacy and six health outcomes and decompose these associations with health literacy's covariates. METHODS Cross-sectional data from the Young Adult Survey Switzerland was used for the analyses (n = 5959, age = 18-25). Logistic regression and KHB decomposition analyses were applied to estimate health literacy's coefficients and confounding percentages. RESULTS Eleven covariates were associated with health literacy (p < 0.001). Ten covariates reduced the naïve health literacy coefficient when included in the regression models (confounding percentages: 36.7-86.9%). In three out of six models, the confounding effects led to non-significant health literacy coefficients. CONCLUSIONS We found that health literacy's associations with health outcomes are confounded by socioeconomic, material, psychosocial, and health-related factors. More investigations on the causal importance of health literacy, respectively, on its potential to health promotion are required.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Abel, Thomas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1661-8556

Publisher:

Springer

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

02 Apr 2019 12:11

Last Modified:

07 May 2020 11:41

Publisher DOI:

10.1007/s00038-019-01236-x

PubMed ID:

30918975

Uncontrolled Keywords:

Decomposition analysis Determinants of health Health behavior Health literacy Health status Young adults

BORIS DOI:

10.7892/boris.129835

URI:

https://boris.unibe.ch/id/eprint/129835

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