Health Literacy Survey 2014 The right of every person to maintain - - PowerPoint PPT Presentation

Malta Health Literacy Survey 2014

The right of every person to maintain and improve the quality of life throughout the life-course

Health Literacy

Find Understand Judge Apply Health Promotion Disease Prevention Health Care

The comprehensive HLS-EU definition

• f Health Literacy

The Tool - HLS-EU concept in practice (the HLS-EU-Q16 matrix)

Health Literacy Finding information relevant to health (FHI) Understand information relevant to health (UHI) Judge information relevant to health (JHI) Apply information relevant to health (AHI) Total statements Health Care 1, 2 3, 4 5 6, 7 7 Disease Prevention 8 9, 10 11 12 5 Health Promotion 13 14, 15 16

• 4

Total statements 4 6 3 3 16

Survey Methodology

• Conducted in July 2014 by the National Statistics

Office.

• A stratified random sample of persons aged 18

years and over and living in private households, stratified by district, age group (18-32, 33-48, 49- 64 and 65+) and gender.

• Quotas were applied on the strata in order to
• btain a fully representative net sample of 1,500

persons.

• Information from 1,514 completed responses was

gathered using the validated and standardised HLS-EU-Q16 questionnaire through the use of Computer Assisted Telephone Interviewing (CATI).

Findings

30 12 19 20 14 17 34 40 10 32 29 16 28 25 26 24 57 59 52 51 48 49 54 52 44 63 60 54 64 62 61 57 11 24 25 21 31 28 10 6 31 4 9 25 7 12 12 16 1 1 2 2 2 2 1 1 2 2 1 1 1 4 2 6 5 5 1 1 13 1 2 3 1 1 3 10 20 30 40 50 60 70 80 90 100

judge behaviour related to health understand media information understand advice of family/friends find activities for mental well-being using media info to protect yourself judge reliability media info understand health screenings understand health warnings find info mental health problems follow professional instructions use professional info for decisions judge need of a second opinion understand instructions on medicine understand doctor info find info to get professional help find info on treating illnesses

Percentage Distribution of Survey Responses (n=1514)

Very Easy Fairly Easy Fairly Difficult Very Difficult Don't Know

Easy to…..

• Understand (87%)and follow (94.6%)

professional instructions

• Understand health warnings (92.5%)
• Understand instructions on medicines

(92.4%)

• Understand health screenings (88.3%)
• Judge behaviour related to health (87%)

• Find information on common mental

health problems (45.7%)

• Use media information to protect
• neself from illness (38%)
• Judge the reliability of health

information from the media (35%)

• Judge need of second opinion (31.5%)

Don’t know or difficult to…..

HEALTH CARE

1 find information on treatments of illnesses that concern you 80.5% 19.5% 2 find out where to get professional help when you are ill 86.8% 13.2% 3 understand what your doctor tells you 87.0% 13.0% 4 understand your doctor's or pharmacist's instructions on how to take a prescribed medicine 92.4% 7.8% 5 judge when you may need to get a second opinion from another doctor 69.5% 30.5% 6 use information the doctor gives you to make decisions about your illness 88.3% 11.7% 7 follow instructions from your doctor

• r pharmacist

94.6% 5.3% 13 find out about activities that are good for your mental well-being 70.6% 29.5% 14 understand advice on health from family members or friends 70.4% 29.7% 15 understand information in the media on how to get healthier 70.8% 29.2% 16 judge which everyday behaviour is related to your health 87.0% 12.9%

HEALTH PROMOTION

8 find information on how to manage mental health problems like stress and depression 54.3% 45.7% 9 understand health warnings about behaviour such as smoking, low physical activity and drinking too much 92.5% 7.5% 10 understand why you need health screenings 88.3% 11.7% 11 judge if the information

• n health risks in the

media is reliable 65.0% 35.0% 12 decide how you can protect yourself from illness based on information in the media 62.0% 38.0%

DISEASE PREVENTION

>80% EASY/FAIRLY EASY 60-80% EASY/FAIRLY EASY <60% EASY/FAIRLY EASY

1 find information on treatments of illnesses that concern you 80.5% 19.5% 2 find out where to get professional help when you are ill 86.8% 13.2% 8 find information on how to manage mental health problems like stress and depression 54.3% 45.7% 13 find out about activities that are good for your mental well-being 70.6% 29.5%

FIND INFORMATION

3 understand what your doctor tells you 87.0% 13.0% 4 understand your doctor's or pharmacist's instructions on how to take a prescribed medicine 92.4% 7.8% 9 understand health warnings about behaviour such as smoking, low physical activity and drinking too much 92.5% 7.5% 10 understand why you need health screenings 88.3% 11.7% 14 understand advice on health from family members or friends 70.4% 29.7% 15 understand information in the media on how to get healthier 70.8% 29.2%

UNDERSTAND INFORMATION

5 judge when you may need to get a second

• pinion from another

doctor 69.5% 30.5% 11 judge if the information

• n health risks in the

media is reliable 65.0% 35.0% 16 judge which everyday behaviour is related to your health 87.0% 12.9%

JUDGE INFORMATION

6 use information the doctor gives you to make decisions about your illness 88.3% 11.7% 7 follow instructions from your doctor or pharmacist 94.6% 5.3% 12 decide how you can protect yourself from illness based on information in the media 62.0% 38.0%

USE INFORMATION

Health Literacy

Find Understand Judge Apply Health Promotion Disease Prevention Health Care

From Likert Scale to Literacy Index

Each statement in the national questionnaire was given a numeric value: – ‘very difficult’ as having a numeric value of ‘1’ and ‘very easy’ as having a numeric value of ‘4’. – ‘Don’t know’ were not given any value in order not to bias results. For each respondent, the average value of all statements was worked out and then converted to a metric score in order to obtain the relevant Health Literacy index. The following formula was applied:

Literacy Index = (Mean -1) * (50/3)

Where:

• Mean…..is the mean of all participating items for each Individual
• 1 …………is the minimal possible value of the mean (leads to a minimum

value of the index of 0)

• 3 ………..is the range of the mean
• 50…….is the chosen maximum value of the new metric.

Classification of any Health Literacy Index

(0 minimum; 50 maximum)

Level Range Excellent 42-50 Sufficient 33-41.99 Problematic 25-32.99 Inadequate 0-24.99

Source: HLS-EU Consortium

General Health Literacy Index Mean for Malta Malta 34.01 Male 34.06 Female 33.94

Malta has a SUFFICIENT level of General Health Literacy

Comparative Distribution of Health Literacy Indices Malta & HLS-EU*

Mean General Health Index Healthcare Index Disease Prevention Index Health promotion Index

Malta 34.0 34.8 31.5 31.7 HLS-EU* 33.8 34.7 34.2 32.5 NL 37.1 38 37.7 35.7

*HLS-EU was carried out in Austria, Bulgaria, Germany (NR Westphalia), Greece, Ireland, Netherlands, Poland, Spain

Distribution of General Health Literacy for Malta and HLS-EU*

Level % Distribution MT (n=1514) % Distribution (HLS-EU*) Excellent (42-50) 9.2 16.5 Sufficient (33-41.99) 45.0 36.0 Problematic (25-32.99) 42.5 35.2 Inadequate (0-24.99) 3.3 12.4

*HLS-EU was carried out in Austria, Bulgaria, Germany (NR Westphalia), Greece, Ireland, Netherlands, Poland, Spain

(45.8%) (47.6%)

6.0% 20.0% 11.1% 28.3% 29.0% 33.1% 46.3% 40.3% 49.1% 19.4% 10.7% 6.8% Health Care Disease Prevention Health Promotion

Percentage Distribution of Literacy for Health Care, Disease Prevention and Health Promotion

Inadequate Problematic Sufficient Excellent

Levels of

Health Promotion Literacy

and

Disease Prevention Literacy

are not as good as levels relating to

Health Care Literacy

10 20 30 40 50

Inadequate Malta Inadequate EU Problematic Malta Probelmatic EU Sufficient Malta Sufficient EU Excellent Malta Excellent EU

Percent %

Percentage levels for Health Care Literacy

5 10 15 20 25 30 35 40 45

Inadequate Malta Inadequate EU Problematic Malta Probelmatic EU Sufficient Malta Sufficient EU Excellent Malta Excellent EU Percent %

Percentage levels for Disease Prevention Literacy

10 20 30 40 50 60

Inadequate Malta Inadequate EU Problematic Malta Probelmatic EU Sufficient Malta Sufficient EU Excellent Malta Excellent EU

Percent %

Percentage levels for Health Promotion Literacy

45.8% of the Maltese Population have

problematic or inadequate Health Literacy

Health Literacy Level and Social Determinants

No statistically significant difference was observed for gender, marital status, types of households or persons residing in different districts

Social determinants found to influence

• n Health Literacy levels include:

Health Literacy

Education Financial Status Social Status Age

Vulnerable Groups (1)

• 61.6% of persons with bad self-perceived health have

a limited level of health literacy

Bad self-perceived health

• 60.6% of persons with low self-declared social status

have a limited level of health literacy

Low social status

• 56.3% of persons with more than one long term

illness have a limited level of health literacy

More than one long term illness

Vulnerable Groups (2)

• 56.1% of persons residing in Gozo have a limited level
• f health literacy

Gozo

• 54.4% of persons over 76 years of age have a limited

level of health literacy

76+ years

• 48.9% of persons with Pre-primary and Primary Levels
• f Education have a limited health literacy

Low Education level

31 32 33 34 35 36 37 38 Less than €800 €800-under €1850 €1850-under €2400 €2400-under €2950 €2950-under €3600 €3600 and

• ver

Mean GHL

Net Household Income

Net Household Income and Mean General Health Literacy level

Mean HL level

Health Behaviour as a predictor of Health Literacy Levels

31 32 33 34 35 36 37 38

Underweight Normal Overweight Obese Unknown

M e a n G H L Body Mass Index

Body Mass Index and Mean General Health Literacy level

General HL Mean level

31 32 33 34 35 36 37 38 No illness One illness More than One Illness M e a n G H L Long Term Illnesses

Long Term Illnesses and Mean General Health Literacy level

General HL Mean level

31 32 33 34 35 36 37 38 Very Good Good Fair Bad Very Bad Mean GHL Self Assessed Health

Distribution of Self Assessed Health by Mean General Health Literacy level

Mean HL level

Body Mass Index and the

presence of Long term

Illnesses are inversely

correlated with Health Literacy

Self-assessed Health seems

to be the best proxy indicator of Health Literacy Level

Health Literacy Levels and Service Use

Emergency Service Use

Persons with low HL levels tend to be admitted to accident and emergency more

• ften.

This increases costs!

31 32 33 34 35 36 37 38 No use of emergency services 1 to 2 times 3 or more times Mean HL Emergency Service Use

HL level by frequency of emergency service use

Persons who made use of other health professional services i.e. allied healthcare professionals, were significantly more health literate than the rest of the other subgroups for all dimensions of Health Literacy.

Conclusions (1)

• Malta has a SUFFICIENT level of

Health Literacy with a Mean General Health Literacy of 34.0

• This is equivalent to the Mean

General Health Literacy in Europe but is considerably less than of the best i.e. the Netherlands

Conclusions (2)

• Limited Health Literacy is a

problem of nearly one in every two Maltese persons

• Levels of Disease Prevention

Literacy and Health Promotion Literacy are not as good as Health Care Literacy levels

Conclusions (3)

• Respondents had difficulty or did

not know how to:

• find information on common mental

health problems

• use media information to protect

themselves from illness

• judge the credibility of health

information from the media

Conclusions (4)

• Persons at risk of limited Health

Literacy include:

–Bad self-perceived health –Low self-assessed social status –More than one long-term illness –Gozo residents –Age 76+ years –Pre-primary or primary education

Conclusions (5)

• Body Mass Index and the presence
• f Long term Illnesses are

inversely correlated with Health Literacy

• Level of Self-assessed Health

seems to be the best proxy indicator of Health Literacy Level

Conclusions (6)

• Health Literacy is influencing:

– How persons behave – How persons participate – How persons use health services

therefore Health Literacy matters

Recommendations (1)

• Support and advocate for better

mental health and wellbeing

• Analyse deeper and act upon the

interaction between health messages and media messages from a citizen information perspective

Recommendations (2)

• Address Health Literacy to:

– strengthen empowerment – improve outcomes – reduce inequalities – save costs – improve sustainability Health Literacy - a strong policy tool

Recommendations (3)

• Identify and address Health

Literacy gaps at the professional – patient interface because

Health Literacy is the duty of every professional & the right of every citizen

THANK YOU