Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Université Catholique de Louvain, Louvain-la-Neuve, Belgium.
BMC Public Health. 2021 Jul 10;21(1):1365. doi: 10.1186/s12889-021-11437-w.
The importance of health literacy in dealing with the COVID-19 epidemic has been emphasized but scarcely addressed empirically. In this study, the association of health literacy with mental health, compliance with COVID-19 preventive measures and health prospects was assessed in a Belgian context.
Data were extracted from the third of a series of cross-sectional online COVID-related surveys (n = 32,794). Data collection took place for 1 week starting the 28th of May 2020. People residing in Belgium and aged 18 years or older could participate. Data were collected on sociodemographic background, health literacy, multimorbidity, mental health (depression, anxiety, sleeping disorder, vitality), knowledge about COVID-19, compliance with COVID-19 measures (hygiene, physical distance, covering mouth and nose on public transport and in places where physical distance cannot be respected), and health prospects (risk for health when returning to normal life and possibility of infection). Prevalence Ratio (PR) of poor mental health, non-compliance with the measures and health prospects in relation to health literacy were calculated using Poisson regressions.
People showing sufficient health literacy were less likely to suffer from anxiety disorders (PR = 0.47, 95% CI = [0.42-0.53]), depression (PR = 0.46, 95% CI = [0.40-0.52]) and sleeping disorders (PR = 0.85, 95% CI = [0.82-0.87]), and more likely to have optimal vitality (PR = 2.41, 95% CI = [2.05-2.84]) than people with low health literacy. They were less at risk of not complying with the COVID-19 measures (PR between 0.60 and 0.83) except one (covering mouth and nose in places where physical distance cannot be respected). Finally, they were less likely to perceive returning to normal life as threatening (PR = 0.70, 95% CI = [0.65-0.77]) and to consider themselves at risk of an infection with COVID-19 (PR = 0.75, 95% CI = [0.67-0.84]). The associations remained significant after controlling for COVID-19 knowledge and multimorbidity.
These results suggest that health literacy is a crucial factor in managing the COVID-19 epidemic and offer a perspective for future studies that target health literacy in the context of virus outbreaks.
在应对 COVID-19 疫情时，健康素养的重要性已被强调，但在实证研究中却鲜有涉及。本研究评估了在比利时背景下健康素养与心理健康、遵守 COVID-19 预防措施和健康前景之间的关联。
本研究数据来自一系列横断面在线 COVID 相关调查中的第三轮（n=32794）。数据收集于 2020 年 5 月 28 日开始的一周内进行。年龄在 18 岁及以上、居住在比利时的人可以参与调查。数据收集内容包括社会人口统计学背景、健康素养、多种合并症、心理健康（抑郁、焦虑、睡眠障碍、活力）、COVID-19 知识、遵守 COVID-19 措施（卫生、物理距离、在公共交通工具和无法保持物理距离的地方捂住口鼻）以及健康前景（回归正常生活的健康风险和感染的可能性）。使用泊松回归计算健康素养与心理健康不良、措施不遵守和健康前景之间的不良心理健康、措施不遵守和健康前景的患病率比（PR）。
具有足够健康素养的人患焦虑障碍（PR=0.47，95%CI[0.42-0.53]）、抑郁（PR=0.46，95%CI[0.40-0.52]）和睡眠障碍（PR=0.85，95%CI[0.82-0.87]）的可能性较低，活力最佳的可能性较高（PR=2.41，95%CI[2.05-2.84]），而非健康素养较低的人。他们不太可能不遵守 COVID-19 措施（PR 在 0.60 到 0.83 之间），除了在无法保持物理距离的地方捂住口鼻这一条。最后，他们认为回归正常生活没有威胁的可能性较低（PR=0.70，95%CI[0.65-0.77]），认为自己有感染 COVID-19 的风险的可能性较低（PR=0.75，95%CI[0.67-0.84]）。在控制了 COVID-19 知识和多种合并症后，这些关联仍然显著。
这些结果表明，健康素养是管理 COVID-19 疫情的一个关键因素，并为未来针对病毒爆发时健康素养的研究提供了一个视角。
