title: Health literacy, self-perceived health and self-reported chronic morbidity among older people in Kosovo.
abstract: The aim was to describe health literacy among the older population of Kosovo, an Albanian speaking post-war country in the Western Balkans, in the context of self-perceived health status and self-reported chronic morbidity. A cross-sectional study was conducted in Kosovo in 2011 including 1753 individuals aged ≥ 65 years (886 men, 867 women; mean age 73.4 ± 6.3 years; response rate: 77%). Participants were asked to assess, on a scale from 1 to 5, their level of difficulty with regard to access, understanding, appraisal and application of health information. Sub-scale scores and an overall health literacy score were calculated for each participant. Information on self-perceived health status, presence and number of chronic diseases and socioeconomic characteristics was also collected. Mean values of the overall health literacy score and all sub-scale scores (access, understanding, appraisal and application) were lower among older people who reported a poorer health status or at least one chronic condition compared with individuals who perceived their health status as good or had no chronic conditions (p < 0.001 for all). Our findings provide valuable evidence on the independent and inverse association between health literacy levels and self-perceived health and chronic morbidity in this post-war European population. The putative link with chronic morbidity and lower adherence to health services is hard to establish through this cross-sectional study. Prospective population-based studies should be conducted in Kosovo and other transitional settings to replicate these findings and properly address the causal relationship between health literacy and health status.
authors.affiliation: Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
authors.forename: Ervin
authors.initials: E
authors.lastname: Toci
authors.affiliation: Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
authors.forename: Genc
authors.initials: G
authors.lastname: Burazeri
authors.affiliation: Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
authors.forename: Naim
authors.initials: N
authors.lastname: Jerliu
authors.affiliation: Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
authors.forename: Kristine
authors.initials: K
authors.lastname: Sørensen
authors.affiliation: Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
authors.forename: Naser
authors.initials: N
authors.lastname: Ramadani
authors.affiliation: Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
authors.forename: Bajram
authors.initials: B
authors.lastname: Hysa
authors.affiliation: Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
authors.forename: Helmut
authors.initials: H
authors.lastname: Brand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology; D054626:Consumer Health Information; D003430:Cross-Sectional Studies; D005260:Female; D057220:Health Literacy / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D063826:Kosovo / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012649:Self Concept; D057566:Self Report; D012959:Socioeconomic Factors
keywords: chronic morbidity; health literacy; older people; self-perceived health