Functional health literacy among primary health-care patients: data from the Belgrade pilot study

Over the last decade, health literacy has become a vibrant area of research. Our objective was to evaluate health literacy and its association with socio-demographic variables, self-perception of health and the presence of chronic conditions in primary health-care patients.

A cross-sectional study among 120 patients was conducted in two primary health-care centers. The test of functional health literacy in adults, a 50-item reading comprehension and 17-item numerical ability test (score, 0-100) were administered. Chi-square test and logistic regression analyses were applied.

Inadequate and marginal health literacy existed in 43 participants (41.0%), and adequate health literacy was present in 62 participants (59.0%). Functional health literacy was significantly different by location, gender, age, marital status, employment, education, material status, self-perception of health and presence of chronic conditions. Based on the multivariate analysis, health literacy was significantly associated with the participant's age (odds ratio [OR], 4.86; 95% confidence interval [CI], 2.41-9.80; P = 0.000), level of education (OR, 4.48; 95% CI, 1.73-11.57; P = 0.002) and chronic conditions (OR, 1.90; 95% CI, 1.16-3.11; P = 0.010).

These results provide evidence that limitations in functional health literacy are widespread among primary health-care patients and encourage efforts for further monitoring. Low health literacy may impair a patient's understanding of health messages and limit their ability to attend to their medical problems.