Malta Health Literacy Survey 2014
The right of every person to maintain and improve the quality of life throughout the life-course
Find Health Disease Promotion Prevention Health Apply Understand Literacy Health The Care comprehensive HLS-EU definition Judge of Health Literacy
The Tool - HLS-EU concept in practice (the HLS-EU-Q16 matrix) Finding Understand Judge Apply Health information information information information Total Literacy relevant to relevant to relevant to relevant to statements health (FHI) health (UHI) health (JHI) health (AHI) Health Care 1, 2 3, 4 5 6, 7 7 Disease 8 9, 10 11 12 5 Prevention Health 13 14, 15 16 - 4 Promotion Total 4 6 3 3 16 statements
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 obtain 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
Percentage Distribution of Survey Responses (n=1514) find info on treating illnesses 24 57 16 1 3 find info to get professional help 26 61 12 0 1 understand doctor info 25 62 12 0 1 understand instructions on medicine 28 64 7 1 judge need of a second opinion 16 54 25 2 3 use professional info for decisions 29 60 9 0 2 follow professional instructions 32 63 4 0 1 find info mental health problems 10 44 31 2 13 understand health warnings 40 52 6 1 1 understand health screenings 34 54 10 1 1 judge reliability media info 17 49 28 2 5 using media info to protect yourself 14 48 31 2 5 find activities for mental well-being 20 51 21 2 6 understand advice of family/friends 19 52 25 2 2 understand media information 12 59 24 1 4 judge behaviour related to health 30 57 11 1 1 0 10 20 30 40 50 60 70 80 90 100 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%)
Don’t know or difficult to….. • Find information on common mental health problems (45.7%) • Use media information to protect oneself from illness (38%) • Judge the reliability of health information from the media (35%) • Judge need of second opinion (31.5%)
HEALTH CARE DISEASE PREVENTION 1 find information on treatments of 80.5% 19.5% 8 find information on how 54.3% 45.7% illnesses that concern you to manage mental health 2 find out where to get professional 86.8% 13.2% problems like stress and help when you are ill depression 3 understand what your doctor tells 87.0% 13.0% 9 understand health 92.5% 7.5% you warnings about 4 understand your doctor's or 92.4% 7.8% behaviour such as pharmacist's instructions on how to smoking, low physical take a prescribed medicine activity and drinking too 5 judge when you may need to get a 69.5% 30.5% much second opinion from another doctor 10 understand why you 88.3% 11.7% 6 use information the doctor gives you 88.3% 11.7% need health screenings to make decisions about your illness 11 judge if the information 65.0% 35.0% 7 follow instructions from your doctor 94.6% 5.3% on health risks in the or pharmacist media is reliable 12 decide how you can 62.0% 38.0% protect yourself from HEALTH PROMOTION illness based on information in the media 13 find out about activities that are 70.6% 29.5% good for your mental well-being 14 understand advice on health from 70.4% 29.7% >80% EASY/FAIRLY EASY family members or friends 15 understand information in the 70.8% 29.2% 60-80% EASY/FAIRLY EASY media on how to get healthier 16 judge which everyday behaviour is 87.0% 12.9% <60% EASY/FAIRLY EASY related to your health
FIND INFORMATION UNDERSTAND INFORMATION find information on understand what your doctor 3 1 treatments of illnesses tells you 87.0% 13.0% that concern you 80.5% 19.5% understand your doctor's or find out where to get 4 pharmacist's instructions on how 2 professional help when to take a prescribed medicine 92.4% 7.8% you are ill 86.8% 13.2% find information on how understand health warnings to manage mental health about behaviour such as 9 8 problems like stress and smoking, low physical activity depression 54.3% 45.7% and drinking too much 92.5% 7.5% find out about activities understand why you need health 10 13 that are good for your screenings 88.3% 11.7% mental well-being 70.6% 29.5% understand advice on health 14 JUDGE INFORMATION from family members or friends 70.4% 29.7% understand information in the 15 media on how to get healthier 70.8% 29.2% judge when you may need to get a second USE INFORMATION 5 opinion from another doctor 69.5% 30.5% use information the doctor 6 gives you to make decisions judge if the information 11 about your illness 88.3% 11.7% on health risks in the media is reliable 65.0% 35.0% 7 follow instructions from your doctor or pharmacist 94.6% 5.3% judge which everyday decide how you can protect 16 behaviour is related to 12 yourself from illness based on your health 87.0% 12.9% information in the media 62.0% 38.0%
Find Health Disease Promotion Prevention Health Apply Understand Literacy Health Care Judge
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* General Disease Health Healthcare Mean Health Prevention promotion Index Index Index 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* % Distribution % Distribution Level MT (n=1514) (HLS-EU*) Excellent 9.2 16.5 (42-50) Sufficient 45.0 36.0 (33-41.99) Problematic 42.5 35.2 (25-32.99) (45.8%) (47.6%) Inadequate 3.3 12.4 (0-24.99) * HLS-EU was carried out in Austria, Bulgaria, Germany (NR Westphalia), Greece, Ireland, Netherlands, Poland, Spain
Percentage Distribution of Literacy for Health Care, Disease Prevention and Health Promotion Inadequate Problematic Sufficient Excellent 6.8% 10.7% 19.4% 40.3% 49.1% 46.3% 29.0% 33.1% 28.3% 20.0% 11.1% 6.0% Health Care Disease Prevention Health Promotion
Levels of Health Promotion Literacy and Disease Prevention Literacy are not as good as levels relating to Health Care Literacy
Percentage levels for Health Care Literacy Excellent EU Excellent Malta Sufficient EU Sufficient Malta Probelmatic EU Problematic Malta Inadequate EU Inadequate Malta 0 10 20 30 40 50 Percent %
Percentage levels for Disease Prevention Literacy Excellent EU Excellent Malta Sufficient EU Sufficient Malta Probelmatic EU Problematic Malta Inadequate EU Inadequate Malta 0 5 10 15 20 25 30 35 40 45 Percent %
Percentage levels for Health Promotion Literacy Excellent EU Excellent Malta Sufficient EU Sufficient Malta Probelmatic EU Problematic Malta Inadequate EU Inadequate Malta 0 10 20 30 40 50 60 Percent %
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 on Health Literacy levels include: Education Health Financial Age Status Literacy Social Status
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