title: Health literacy, associated lifestyle and demographic factors in adult population of an English city: a cross-sectional survey.
abstract: Lower health literacy is a public health issue that follows a social gradient, potentially reinforcing existing health inequalities. However, levels of health literacy in particular populations can be unclear and are a key to identifying effective public health interventions. This research examined health literacy levels in Stoke-on-Trent, where 31.2% of the population live in areas classified amongst the 10% most deprived in England.
  
  
  
  A cross-sectional survey using the Newest Vital Sign examined associations with demographic factors, lifestyle behaviours, Internet use and self-rated health. The sample (n = 1046) took account of variance in levels of health literacy by age, educational attainment and deprivation. Bivariate logistic regression and multivariate logistic regression were used to estimate associations with health literacy when adjusted for other demographic factors and lifestyle behaviours.
  
  
  
  Nine hundred and seventy-two respondents completed the health literacy measure (93%): 277 (28.5%) scored low, 228 (23.5%) scored marginal and 467 (48.0%) scored adequate. Associations with higher rates of limited health literacy included older age, lower educational level, lower income, perceived poor health and lack of access to the Internet.
  
  
  
  Given the complexity of factors influencing health literacy interdisciplinary approaches across health and social care and the voluntary sector are essential in identifying and developing appropriate interventions.
authors.affiliation: Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Protheroe
authors.affiliation: Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Whittle
authors.affiliation: Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Bartlam
authors.affiliation: School of Psychology, Keele University, Keele, UK.
authors.forename: Emee Vida
authors.initials: EV
authors.lastname: Estacio
authors.affiliation: Public Health Directorate, Stoke-on-Trent City Council, Stoke-on-Trent, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Clark
authors.affiliation: Public Health Directorate, Stoke-on-Trent City Council, Stoke-on-Trent, UK.
authors.forename: Judith
authors.initials: J
authors.lastname: Kurth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003710:Demography; D004739:England; D005260:Female; D057220:Health Literacy; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: health literacy; inequalities; public health