The relationship between health literacy and health outcomes among male young adults: exploring confounding effects using decomposition analysis

Rüegg, René; Abel, Thomas (2019). The relationship between health literacy and health outcomes among male young adults: exploring confounding effects using decomposition analysis International Journal of Public Health, 64(4), pp. 535-545. Springer 10.1007/s00038-019-01236-x

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Objectives: Previous studies indicate substantial correlations between low health literacy and poor health outcomes. However, empirical findings remain inconsistent and are theoretically challenging. In this study, we conceptually place health literacy within an established model of health inequality. Studying multiple pathways, we estimate the associations between health literacy and six health outcomes and decompose these associations with health literacy’s covariates. Methods: Cross-sectional data from the Young Adult Survey Switzerland was used for the analyses (n = 5959, age = 18–25). Logistic regression and KHB decomposition analyses were applied to estimate health literacy’s coefficients and confounding percentages. Results: Eleven covariates were associated with health literacy (p<0.001). Ten covariates reduced the naïve health literacy coefficient when included in the regression models (confounding percentages: 36.7–86.9%). In three out of six models, the confounding effects led to non-significant health literacy coefficients. Conclusions: We found that health literacy’s associations with health outcomes are confounded by socioeconomic, material, psychosocial, and health-related factors. More investigations on the causal importance of health literacy, respectively, on its potential to health promotion are required.

Item Type:	Journal Article (Original Article)
Division/Institute:	School of Social Work > Social Organisation focus area School of Social Work School of Social Work > Institute for Organisation and Social Service Management
Name:	Rüegg, René0000-0002-7276-7265 and Abel, Thomas
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
ISSN:	1661-8556
Publisher:	Springer
Language:	English
Submitter:	René Rüegg
Date Deposited:	08 Oct 2019 11:30
Last Modified:	18 Dec 2020 13:29
Publisher DOI:	10.1007/s00038-019-01236-x
Additional Information:	ISSN 1661-8564 (Online)
Uncontrolled Keywords:	Health literacy, Determinants of health, Health status, Health behavior, Decomposition analysis, Young adults
ARBOR DOI:	10.24451/arbor.8186
URI:	https://arbor.bfh.ch/id/eprint/8186