title: Health literacy, socioeconomic status and self-rated health in Japan.
abstract: Health literacy (HL) is a key determinant of health in a contemporary society characterized by abundant information. Previous studies have suggested that basic or functional HL is positively associated with health, whereas evidences on the association between health and communicative/critical HL are scarce. Furthermore, confounding by socioeconomic status on HL-health association has been poorly tested. Using cross-sectional data from a nationally representative community-based survey in Japan, we investigated whether communicative/critical HL is associated with self-rated health independent of socioeconomic status. A total of 1237 subjects participated in this study; the response rate was 62%. To measure communicative/critical HL, we used three questions assessing the respondents' ability to select, to communicate to others and to evaluate specific health-related information. Potential confounders included demographic factors, household income, employment status, and educational attainment. A multivariate model revealed that good self-reported health was significantly associated with younger age [odds ratio (OR), 0.99; 95% confidence interval (CI), 0.97-0.99], employment (OR, 2.89; 95% CI, 1.06-7.88) and higher communicative/critical HL scores (OR 2.75; 95%CI, 1.93-3.90). Respondents with lower education were likely to have poorer communicative/critical HL. These results imply that to close the health gap, policy interventions should focus on the promotion of HL among deprived sociodemographic groups.
authors.affiliation: Department of Fundamental and Clinical Nursing, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan yohkof@yamanashi.ac.jp.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Furuya
authors.affiliation: Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kondo
authors.affiliation: Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan.
authors.forename: Zentaro
authors.initials: Z
authors.lastname: Yamagata
authors.affiliation: Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Hashimoto
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D057220:Health Literacy / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D057566:Self Report; D012959:Socioeconomic Factors
keywords: Japan; health literacy; perceived health; socioeconomic status