Research Division, Institute of Mental Health, Singapore 539747, Singapore.
Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore 730676, Singapore.
Int J Environ Res Public Health. 2021 Sep 3;18(17):9316. doi: 10.3390/ijerph18179316.
Health literacy is a key determinant of the public health and health climate of the nation. This study examined the functional health literacy of the nation, factors associated with health literacy, and its relationship with diabetes recognition. This cross-sectional survey recruited participants (N = 2895) who were 18 years and above from a population registry through disproportionate stratified sampling. The Brief Health Literacy Screen and other questionnaires were administered through face-to-face interviews, in one of the four national languages (English, Chinese, Malay or Tamil). The majority (80.5%) had adequate functional health literacy and were able to recognise symptoms of diabetes correctly (83.5% overall; 83.7% and 82.2% in those with adequate and inadequate health literacy, respectively). Those with inadequate health literacy had a higher incidence of chronic conditions ( < 0.001) compared to those with adequate health literacy in bivariate analysis. The majority of the sample had sufficient levels of physical activity (83.3%), and more than half reported an unhealthy lifestyle (57.4%). Older age, Chinese ethnicity, those who were employed, with lower education (secondary or below), and were married had significantly higher odds of inadequate health literacy. Health literacy was not associated with lifestyle, physical activity, chronic conditions and diabetes recognition. Health literacy interventions should focus on the disadvantaged social groups for improving their health literacy.
健康素养是国家公共卫生和健康状况的关键决定因素。本研究旨在调查国民的功能性健康素养、与健康素养相关的因素，以及其与糖尿病识别能力的关系。本横断面研究通过不均衡分层抽样，从人口登记处招募了 18 岁及以上的参与者（N=2895 人）。通过面对面访谈，以四种国家语言（英语、中文、马来语或泰米尔语）之一，使用简短健康素养筛查和其他问卷进行调查。大多数参与者（80.5%）具有足够的功能性健康素养，能够正确识别糖尿病症状（总体正确识别率为 83.5%；健康素养充足和不足的参与者分别为 83.7%和 82.2%）。在单变量分析中，与健康素养充足的参与者相比，健康素养不足的参与者患有慢性疾病的比例更高（<0.001）。大多数参与者（83.3%）有足够的身体活动水平，超过一半的人报告有不健康的生活方式（57.4%）。年龄较大、华族、有工作、教育程度较低（中学或以下）和已婚的参与者，健康素养不足的几率明显更高。健康素养与生活方式、身体活动、慢性疾病和糖尿病识别能力无关。健康素养干预措施应针对弱势群体，以提高他们的健康素养。
