Health Literacy Levels and Self-Rated Health in the state of Delaware: a cross-sectional Study

Abstract Background Better health literacy has been found to be associated with better health outcomes across varied populations. This study aimed to (1) examine the health literacy levels of individuals with respect to the extent to which they acquire, understand, appraise, and apply health information, and (2) to assess the relationship between health literacy and self-reported health in the state of Delaware. Methods The sampling frame consisted of 60 purposively selected faith-based organizations across the state of Delaware who predominantly serve minorities. Accounting for clustering design, a sample size was determined based on a Mixed Methods test. In total, 1095 participants responded to a survey questionnaire which included a validated short version of the European Health Literacy Questionnaire (HLS-EU-Q16). The data was analyzed using descriptive statistics, reliability techniques, chi-square test of independence, and ordinal logistic regression. Results The study found that about a quarter of the participants had inadequate level of health literacy and about another quarter had problematic level of health literacy. These results are reflected across the health domains – health care, disease prevention, and health promotion. Health literacy was predictor of self-rated health. The odds of better self-rated health are 0.360 times lower for people with inadequate health literacy levels compared to those with sufficient health literacy. Conclusion Health literacy profoundly shapes health outcomes. The high proportion of people expressing difficulty concerning accessing, comprehending, appraising, and using health information in the health care, disease prevention, and health promotion domains in state of Delaware would require a concerted effort.