Background: Many studies have shown that low health literacy (HL) is associated with several adverse outcomes. In this study, we systematically reviewed the prevalence of low HL in Europe. Methods: PubMed, Embase, and Scopus were searched. Cross-sectional studies conducted in the European Union (EU), published from 2000, investigating the prevalence of low HL in adults using a reliable tool, were included. Quality was assessed with the Newcastle-Ottawa Scale. Inverse-variance random effects methods were used to produce pooled prevalence estimates. A meta-regression analysis was performed to assess the association between low HL and the characteristics of the studies. Results: The pooled prevalence of low HL ranged from of 27% (95% CI: 18–38%) to 48% (95% CI: 41–55%), depending on the literacy assessment method applied. Southern, Western, and Eastern EU countries had lower HL compared to northern Europe (β: 0.87, 95% CI: 0.40–1.35; β: 0.59, 95% CI: 0.25–0.93; and β: 0.72, 95% CI: 0.06–1.37, respectively). The assessment method significantly influenced the pooled estimate: compared to word recognition items, using self-reported comprehensions items (β: 0.61, 95% CI: 0.15–1.08), reading or numeracy comprehensions items (β: 0.77, 95% CI: 0.24–1.31), or a mixed method (β: 0.66, 95% CI: 0.01–1.33) found higher rates of low HL. Refugees had the lowest HL (β: 1.59, 95% CI: 0.26–2.92). Finally, lower quality studies reported higher rates of low HL (β: 0.56, 95% CI: 0.06–1.07). Discussion: We found that low HL is a public health challenge throughout Europe, where one in every three to almost one in every two Europeans may not be able to understand essential health-related material. Additional research is needed to investigate the underlying causes and to develop remedies.

What is the prevalence of low health literacy in European Union member states? A systematic review and meta-analysis / Baccolini, V.; Rosso, A.; Di Paolo, C.; Isonne, C.; Salerno, C.; Migliara, G.; Prencipe, G. P.; Massimi, A.; Marzuillo, C.; De Vito, C.; Villari, P.; Romano, F.. - In: JOURNAL OF GENERAL INTERNAL MEDICINE. - ISSN 0884-8734. - 36:3(2021), pp. 753-761. [10.1007/s11606-020-06407-8]

What is the prevalence of low health literacy in European Union member states? A systematic review and meta-analysis

Baccolini V.
;
Rosso A.;Di Paolo C.;Isonne C.;Salerno C.;Migliara G.;Prencipe G. P.;Massimi A.;Marzuillo C.;De Vito C.;Villari P.;Romano F.
2021

Abstract

Background: Many studies have shown that low health literacy (HL) is associated with several adverse outcomes. In this study, we systematically reviewed the prevalence of low HL in Europe. Methods: PubMed, Embase, and Scopus were searched. Cross-sectional studies conducted in the European Union (EU), published from 2000, investigating the prevalence of low HL in adults using a reliable tool, were included. Quality was assessed with the Newcastle-Ottawa Scale. Inverse-variance random effects methods were used to produce pooled prevalence estimates. A meta-regression analysis was performed to assess the association between low HL and the characteristics of the studies. Results: The pooled prevalence of low HL ranged from of 27% (95% CI: 18–38%) to 48% (95% CI: 41–55%), depending on the literacy assessment method applied. Southern, Western, and Eastern EU countries had lower HL compared to northern Europe (β: 0.87, 95% CI: 0.40–1.35; β: 0.59, 95% CI: 0.25–0.93; and β: 0.72, 95% CI: 0.06–1.37, respectively). The assessment method significantly influenced the pooled estimate: compared to word recognition items, using self-reported comprehensions items (β: 0.61, 95% CI: 0.15–1.08), reading or numeracy comprehensions items (β: 0.77, 95% CI: 0.24–1.31), or a mixed method (β: 0.66, 95% CI: 0.01–1.33) found higher rates of low HL. Refugees had the lowest HL (β: 1.59, 95% CI: 0.26–2.92). Finally, lower quality studies reported higher rates of low HL (β: 0.56, 95% CI: 0.06–1.07). Discussion: We found that low HL is a public health challenge throughout Europe, where one in every three to almost one in every two Europeans may not be able to understand essential health-related material. Additional research is needed to investigate the underlying causes and to develop remedies.
2021
europe; health literacy; meta-analysis; prevalence; systematic review
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
What is the prevalence of low health literacy in European Union member states? A systematic review and meta-analysis / Baccolini, V.; Rosso, A.; Di Paolo, C.; Isonne, C.; Salerno, C.; Migliara, G.; Prencipe, G. P.; Massimi, A.; Marzuillo, C.; De Vito, C.; Villari, P.; Romano, F.. - In: JOURNAL OF GENERAL INTERNAL MEDICINE. - ISSN 0884-8734. - 36:3(2021), pp. 753-761. [10.1007/s11606-020-06407-8]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1522040
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