Faculty of Biology and Medicine (FBM), University of Lausanne, Switzerland.
Faculty of Business and Economics (HEC), University of Lausanne, Switzerland.
Swiss Med Wkly. 2022 Apr 5;152:w30158. doi: 10.4414/smw.2022.w30158. eCollection 2022 Mar 28.
Despite being widely regarded as a major cause of health inequalities, little is known regarding health literacy and its association with certain personal characteristics among older adults in Switzerland. To fill this gap, this study assesses health literacy and its associations with individuals' social, regional, and health characteristics in a nationally representative sample of adults aged 58 years and older in Switzerland.
We use data of 1,625 respondents from a paper-and-pencil self-completion questionnaire (cooperation rate: 94.3%) that was administered as part of wave 8 (2019/2020) of the Survey of Health, Ageing and Retirement in Europe (SHARE) in Switzerland. Health literacy is measured using the short version of the European Health Literacy Survey questionnaire (HLS-EU-Q16). The scale includes 16 items whose dichotomised responses allow the construction of different indices and sub-indices aimed at measuring various aspects of health literacy. We use multivariable regressions to explore how respondents' sociodemographic characteristics are independently associated with health literacy.
Overall, 6.8% of the respondents had inadequate health literacy, 24.6% problematic health literacy, and 68.6% sufficient health literacy. There were significant associations between health literacy and individuals' gender, education, economic situation, and self-rated health. Women had higher levels of health literacy than men (p <0.001). Moreover, a higher education level (p <0.001), fewer financial difficulties (p<0.01), and higher self-rated health (p <0.001) were positively correlated with adequate/higher levels of health literacy.
One-third of older citizens have difficulties managing health-related issues in Switzerland. Individuals with low education, financial difficulties, and bad self-rated health are particularly at risk of being disadvantaged due to their inadequate health literacy level. These findings call for targeted interventions, such as using simplified health or eHealth information tools, improved patient-provider communication and shared decision-making, promoting lifelong learnings activities and health literacy screening for older patients to increase low health literacy and mitigate its consequences, thereby alleviating remaining social health inequalities in the Swiss population.
尽管健康素养被广泛认为是健康不平等的一个主要原因，但对于瑞士老年人的健康素养及其与某些个人特征的关系，人们知之甚少。为了填补这一空白，本研究评估了瑞士一项具有全国代表性的 58 岁及以上成年人样本中健康素养及其与个体社会、地区和健康特征的关联。
我们使用了来自瑞士欧洲健康、衰老和退休调查（SHARE）第八波（2019/2020 年）纸质自填问卷的 1625 名受访者的数据（合作率：94.3%）。健康素养使用欧洲健康素养调查问卷（HLS-EU-Q16）的简短版本进行衡量。该量表包括 16 个项目，其二分响应允许构建旨在衡量健康素养各个方面的不同指数和子指数。我们使用多变量回归来探讨受访者的社会人口统计学特征如何与健康素养独立相关。
总体而言，6.8%的受访者健康素养不足，24.6%的受访者健康素养存在问题，68.6%的受访者健康素养充足。健康素养与个体的性别、教育、经济状况和自我评估健康状况之间存在显著关联。女性的健康素养水平高于男性（p<0.001）。此外，较高的教育水平（p<0.001）、较少的经济困难（p<0.01）和较高的自我评估健康状况（p<0.001）与充足/更高水平的健康素养呈正相关。
瑞士三分之一的老年公民在管理与健康相关的问题方面存在困难。受教育程度较低、经济困难和自我评估健康状况较差的个体由于健康素养水平较低，特别处于劣势地位。这些发现呼吁采取有针对性的干预措施，例如使用简化的健康或电子健康信息工具、改善医患沟通和共同决策、促进终身学习活动以及对老年患者进行健康素养筛查，以提高低健康素养水平并减轻其后果，从而减轻瑞士人口中仍然存在的社会健康不平等现象。
