Prevalence of health literacy and its correlates from a national survey of older adults

Sumithra Devi Suppiah; Rahul Malhotra; Yi Wen Tan; Rebecca Leigh Jessup; Lita Sui Tjien Chew; Wern-Ee Tang; Alison Beauchamp

doi:10.1016/j.sapharm.2023.02.013

Prevalence of health literacy and its correlates from a national survey of older adults

Res Social Adm Pharm. 2023 Jun;19(6):906-912. doi: 10.1016/j.sapharm.2023.02.013. Epub 2023 Feb 27.

Authors

Sumithra Devi Suppiah¹, Rahul Malhotra², Yi Wen Tan³, Rebecca Leigh Jessup⁴, Lita Sui Tjien Chew⁵, Wern-Ee Tang⁶, Alison Beauchamp⁷

Affiliations

¹ School of Rural Health, Monash University, Australia; Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore. Electronic address: sumithra.suppiah@monash.edu.
² Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore; Progamme in Health Sevices and Systems Reseach, Duke-NUS Medical School, Singapore.
³ Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore.
⁴ Allied Health, Northern Health, Epping, Victoria, Australia; Staying Well and Hospital Without Walls Program, Northern Health, Epping, Victoria, Australia; School of Allied Health, Human Services and Sport, LaTrobe University, Bundoora, Victoria, Australia.
⁵ Department of Pharmacy, National Cancer Centre, Singapore; Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
⁶ National Healthcare Group Polyclinics, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
⁷ School of Rural Health, Monash University, Australia.

PMID: 36898905
DOI: 10.1016/j.sapharm.2023.02.013

Abstract

Background: Health literacy (HL) is an important determinant of health. Sub-optimal HL can have profound consequences for individuals and health systems. However, little is known about the HL of older Singaporeans.

Objective: This study determined the prevalence, socio-demographic and health-related correlates of limited and marginal HL among older Singaporeans (≥65 years).

Methods: Data from a national survey were analysed (n = 2327). HL was measured using the 4-item BRIEF with a 5-point response scale (range 4-20), and classified as limited, marginal, and adequate. Multinomial logistic regression models were applied to identify correlates of limited and marginal HL versus adequate HL.

Results: The weighted prevalence of limited HL was 42.0%, marginal HL was 20.4% and adequate HL was 37.7%. In adjusted regression analysis, older adults in advanced age groups with lower education and those living in 1-3 room flats had higher risk of limited HL. Furthermore, having ≥3 chronic diseases (Relative Risk Ratio [RRR] = 1.70, 95% Confidence Interval [95% CI] = 1.15, 2.52), poor self-rated health (RRR = 2.07, 95% CI = 1.56, 2.77), vision impairment (RRR = 2.08, 95% CI = 1.55, 2.80), hearing impairment (RRR = 1.57, 95% CI = 1.15, 2.14) and mild cognitive impairment (RRR = 4.87, 95% CI = 2.12, 11.19) were also associated with limited HL. The likelihood of marginal HL was higher among those with lower education, ≥2 chronic diseases, poor self-rated health (RRR = 1.48, 95% CI = 1.09, 2.00), vision impairment (RRR = 1.45, 95% CI = 1.06, 1.99) and hearing impairment (RRR = 1.50, 95% CI = 1.08, 2.08).

Conclusions: Over two-thirds of older adults faced difficulties in reading, understanding, exchanging, and using health information and resources. There is a pressing need to create awareness about the issues that could result from the mismatch between healthcare system demands and the HL of older adults.

Keywords: Health literacy; Health literacy responsiveness; Older adults; Pharmacy practice; Prevalence.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Educational Status
Health Literacy*
Hearing Loss*
Humans
Logistic Models
Prevalence