title: Health literacy in Suriname.
abstract: Low health literacy is an independent predictor of cardiovascular mortality. However, data on health literacy in low- and middle-income countries are scarce. Therefore, we assessed the level of health literacy in Suriname, a middle-income country with a high cardiovascular mortality.
  
  
  
  We estimated health literacy in a convenience sample at an urban outpatient center in the capital and at a semirural health center, using the validated Rapid Estimate of Adult Literacy in Medicine adapted for the Dutch language (REALM-D) instrument. REALM-D scores vary from 0 to 66 (all correct). The primary outcome was the level of health literacy. Furthermore, we assessed the effect of age, sex, ethnicity, disease history, research location, and level of education on health literacy with multivariable linear regression.
  
  
  
  We included 99 volunteers (52% men; 51% urban research location) with a mean age of 44.9 years (SD 13.4). The mean REALM-D score was moderate: 48.6 (SD 8.1). Greater health literacy was associated with male sex, an urban research location, and a higher educational level.
  
  
  
  Health literacy was moderate in these Surinamese participants. Health care workers should take health literacy into account, and targeted interventions should be developed to improve health literacy in Suriname.
authors.affiliation: a Department of Cardiology , Academic Hospital of Paramaribo , Paramaribo , Suriname.|b Department of Vascular Medicine , Academic Medical Center , Amsterdam , The Netherlands.
authors.forename: Frederieke S
authors.initials: FS
authors.lastname: Diemer
authors.affiliation: b Department of Vascular Medicine , Academic Medical Center , Amsterdam , The Netherlands.
authors.forename: Yentl C
authors.initials: YC
authors.lastname: Haan
authors.affiliation: b Department of Vascular Medicine , Academic Medical Center , Amsterdam , The Netherlands.
authors.forename: Rani V
authors.initials: RV
authors.lastname: Nannan Panday
authors.affiliation: c Department of Internal Medicine , Academic Medical Center , Amsterdam , The Netherlands.
authors.forename: Gert A
authors.initials: GA
authors.lastname: van Montfrans
authors.affiliation: a Department of Cardiology , Academic Hospital of Paramaribo , Paramaribo , Suriname.
authors.forename: Glenn P
authors.initials: GP
authors.lastname: Oehlers
authors.affiliation: c Department of Internal Medicine , Academic Medical Center , Amsterdam , The Netherlands.|d The Amsterdam Institute for Global Health and Development (AIGHD) , Amsterdam , The Netherlands.|e Department of Public Health , Anton de Kom University of Suriname , Paramaribo , Suriname.
authors.forename: Lizzy M
authors.initials: LM
authors.lastname: Brewster
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004522:Educational Status; D005260:Female; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013532:Suriname / Q000453:epidemiology
keywords: Cardiovascular disease; REALM; Suriname; developing countries; ethnicity; health literacy