The Relationship between Health Literacy and Health Disparities: A Systematic Review.
The Relationship between Health Literacy and Health Disparities: A Systematic Review.
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DOI：
10.1371/journal.pone.0145455
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Schulz PJ
中科院分区：
文献类型：
--
作者：
Mantwill S;Monestel-Umaña S;Schulz PJ
健康知识普及通常与健康差距的许多前因有关。然而，卫生知识普及与差距之间关系的确切性质仍不清楚。进行了系统的审查，以更好地了解在多大程度上的健康素养和健康差距之间的关系进行了系统的研究，并确定了潜在的关系和途径。检索了五个数据库，包括PubMed/MEDLINE和CINAHL，以查找同行评审研究。当出版物（1）包括健康素养的有效衡量标准，（2）明确认为健康差距与社会差距有关，如种族/民族或教育，（3）当结果通过比较两个或多个受社会差距影响的群体来呈现时，研究健康素养对健康结果的影响，这些出版物被纳入审查。两名评审员评价了每项研究的入选情况并提取了相关信息。调查结果进行了排序，根据确定的差距和健康素养在解释他们的作用。36项研究被纳入最终综合报告。大多数研究调查了种族/民族差异，其次是一些系统调查教育差异的研究。一些证据表明，健康素养对跨种族/民族和教育差异的自测健康状况的中介作用，以及健康素养和算术对减少药物依从性和药物摄入理解方面的种族/民族差异的潜在影响。总体而言，关于卫生知识普及与差距之间关系的证据仍然好坏参半，而且相当有限。研究在调查的健康（相关）结果和使用的健康素养评估方面存在很大差异。此外，许多研究缺乏对所探讨的差异性质的具体描述，也没有明确说明可能的测试途径。
Health literacy is commonly associated with many of the antecedents of health disparities. Yet the precise nature of the relationship between health literacy and disparities remains unclear. A systematic review was conducted to better understand in how far the relationship between health literacy and health disparities has been systematically studied and which potential relationships and pathways have been identified. Five databases, including PubMed/MEDLINE and CINAHL, were searched for peer-reviewed studies. Publications were included in the review when they (1) included a valid measure of health literacy, (2) explicitly conceived a health disparity as related to a social disparity, such as race/ethnicity or education and (3) when results were presented by comparing two or more groups afflicted by a social disparity investigating the effect of health literacy on health outcomes. Two reviewers evaluated each study for inclusion and abstracted relevant information. Findings were ordered according to the disparities identified and the role of health literacy in explaining them. 36 studies were included in the final synthesis. Most of the studies investigated racial/ethnic disparities, followed by some few studies that systematically investigated educational disparities. Some evidence was found on the mediating function of health literacy on self-rated health status across racial/ethnic and educational disparities, as well as on the potential effect of health literacy and numeracy on reducing racial/ethnic disparities in medication adherence and understanding of medication intake. Overall the evidence on the relationship between health literacy and disparities is still mixed and fairly limited. Studies largely varied with regard to health(-related) outcomes under investigation and the health literacy assessments used. Further, many studies lacked a specific description of the nature of the disparity that was explored and a clear account of possible pathways tested.