[Health Literacy among People with Chronic Illness]

People with chronic illnesses (Pwci) face a variety of challenges in managing their illness and using health care. Thus, their need for information and health literacy (HL) is high. While the topic has already been addressed in international research, there is a lack of studies on health literacy among Pwci in Germany.

The aim was to analyze HL among Pwci in Germany in more detail. For this purpose, cross-sectional data from a total of 499 Pwci of the German Health Literacy Survey (HLS-GER) were used. HL was assessed with the European Health Literacy Survey Questionnaire (HLS-EU-Q 47). Possible differences in the distribution of low HL by socio-demographic characteristics (gender, age, social status, financial resources, educational level and functional HL (assessed with the Newest Vital Sign (NVS)) and disease-related characteristics (number of diseases and disease duration) were tested using chi-square tests. To investigate the influence of these factors on low HL among Pwci, a multiple logistic regression was performed.

Low HL was found in 72.7% of Pwci. Low HL differed greatly according the single domains healthcare, prevention and health promotion. Low social status (OR: 4.4 [1.8; 10.7]), low financial resources (OR: 2.0 [1.2; 3.1]), limited literacy skills (OR: 2.7 [1.4; 5.0]), and an intermediate-level of education (OR: 0.5 [0.3; 0.9]) were associated with low HL in multiple logistic regression. Number and duration of chronic illnesses were not significantly associated with low HL.

The analysis provides initial findings for Germany that need further investigation. However, they already provide important indications for intervention development. It is necessary to develop target group-specific interventions for strengthening personal health literacy of Pwci, specifically addressing people with low social status, low financial resources and limited literacy. To avoid stigmatization, it is also important to address the information demands in the personal environment. Interventions should make it easier to search for, acquire and process information and thus contribute to reducing inequality.