Communicative health literacy and associated variables in nine European countries: results from the HLS19 survey

Metanmo, Salvatore and Finbråten, Hanne Søberg and Bøggild, Henrik and Nowak, Peter and Griebler, Robert and Guttersrud, Øystein and Bíró, Éva and Brigid, Unim and Charafeddine, Rana and Griese, Lennert and Kucera, Zdenek and Le, Christopher and Schaeffer, Doris and Vrdelja, Mitja and Mancini, Julien and Pelikan, Jürgen and Straßmayr, Christa and Griebler, Robert and Dietscher, Christina and van den Broucke, Stephan and Charafeddine, Rana and Yanakieva, Antoniya and Dzhafer, Nigyar and Kucera, Zdeněk and Steflova, Alena and Bøggild, Henrik and Sørensen, Andreas Jull and Mancini, Julien and Allaire, Cécile and Schaeffer, Doris and Bíró, Éva (2024) Communicative health literacy and associated variables in nine European countries: results from the HLS19 survey. SCIENTIFIC REPORTS, 14 (1). No.-30245. ISSN 2045-2322

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Abstract

Our study aimed to report on variables associated with communicative health literacy (COM-HL) in European adults. The HLS 19 survey was conducted in 2019–2021 including nine countries which measured COM-HL by using a validated questionnaire (HLS 19 -COM-P-Q6 with a score ranging from 0 to 100). Linear regression models were used to study variables associated with COM-HL globally (multilevel model with random intercepts and slopes and at country level) and in each country. Additional models studied each of the HLS 19 -COM-P-Q6 items separately. The mean COM-HL score ranged between 62.5 and 76.6 across countries. Among the 18,137 pooled participants, COM-HL was positively associated with age, a higher self-perceived social status, previous training in healthcare, an increasing number of general practitioner visits; and negatively associated with female sex, reported financial difficulties, having a chronic condition and an increasing number of specialist visits. These effects were heterogeneous from one country to another, and from one item to another when analysing the different COM-HL items separately. However, there was a consistent statistically significant association between COM-HL (score and each item) and financial difficulties as well as self-perceived social status in all countries. Interventions to improve communication between patients and physicians should be a high priority to limit communication disparities.

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