Klinger Julia, Berens Eva-Maria, Carol Sarah, Schaeffer Doris
Institut für Soziologie und Sozialpsychologie, Universität zu Köln, Köln, Germany.
Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld, Germany.
Gesundheitswesen. 2023 Oct;85(10):887-894. doi: 10.1055/a-2035-9107. Epub 2023 May 30.
So far, there are hardly any data on the health literacy of persons with a migration background in Germany. The aim of the article was to analyse the health literacy of this population group - particularly persons who originate in Turkey and the former Soviet Union (FSU).
In summer 2020, face-to-face interviews with 525 persons with FSU and 512 persons with Turkish migration background above the age of 18 were carried out across Germany. The interviews were conducted in German, Russian or Turkish. Health literacy was assessed using the internationally developed HLS-Q47 instrument. Bivariate and multivariate analyses were carried out for each immigration group separately considering demographic, socioeconomic, linguistic and migration-specific variables.
Overall, around half of the respondents had low health literacy, with no differences between the immigration groups. In both groups, low educational levels, socioeconomic disadvantages, limited German literacy skills, older age, multiple chronic illnesses and personal experience of immigration were linked with lower health literacy. In multivariate analyses, associations between health literacy and literacy skills, social status, financial deprivation, and chronic illness remained; however, after adjustment, no significant difference persisted by immigration generation.
While a significant proportion of persons with Turkish or FSU migration background in Germany have difficulty dealing with health information, compared with existing studies, they do not have a lower health literacy than the population without a migration background. People with a migration background are therefore not to be regarded as vulnerable to low health literacy in general. Particularly socioeconomically disadvantaged subgroups display low health literacy. Interventions should therefore target these subgroups specifically and consider their living conditions. In addition, people with low literacy skills and German proficiency have greater difficulties in processing health information. This highlights the need for multilingual information, but also for multimedia materials in plain language. Structural measures are necessary for a health-literate health system and for reducing health inequalities.
到目前为止，德国有移民背景人群的健康素养方面几乎没有任何数据。本文的目的是分析这一人群组的健康素养，特别是来自土耳其和前苏联（FSU）的人群。
2020年夏季，在德国各地对525名18岁以上有前苏联移民背景的人和512名有土耳其移民背景的人进行了面对面访谈。访谈用德语、俄语或土耳其语进行。使用国际开发的HLS-Q47工具评估健康素养。分别针对每个移民群体，考虑人口统计学、社会经济、语言和移民特定变量进行双变量和多变量分析。
总体而言，约一半的受访者健康素养较低，各移民群体之间没有差异。在这两个群体中，低教育水平、社会经济劣势、有限的德语读写能力、年龄较大、多种慢性病和移民个人经历都与较低的健康素养相关。在多变量分析中，健康素养与读写能力、社会地位、经济贫困和慢性病之间的关联仍然存在；然而，调整后，移民代际之间没有持续存在显著差异。
虽然德国有土耳其或前苏联移民背景的相当一部分人在处理健康信息方面存在困难，但与现有研究相比，他们的健康素养并不低于没有移民背景的人群。因此，一般而言，不应将有移民背景的人视为易受低健康素养影响的人群。特别是社会经济处于劣势的亚群体健康素养较低。因此，干预措施应特别针对这些亚群体，并考虑他们的生活条件。此外，读写能力和德语水平较低的人在处理健康信息方面有更大困难。这凸显了对多语言信息以及通俗易懂的多媒体材料的需求。建立有健康素养的卫生系统和减少健康不平等需要采取结构性措施。
