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Open AccessArticle

Health Literacy as a Shared Capacity: Does the Health Literacy of a Country Influence the Health Disparities among Immigrants?

Department of Health Science, University of Florence, 50134 Florence, Italy
Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy
Quality and Equity Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(4), 1149;
Received: 18 December 2019 / Revised: 6 February 2020 / Accepted: 6 February 2020 / Published: 12 February 2020
Health literacy (HL) is an individual ability as well as a distributed resource available within an individual’s social network. We performed an explorative study assessing the role of HL as the country-level ecological variable in predicting the health disparities among immigrants. Country-level HL data were obtained from the publicly available first European Health Literacy Survey reports. Individual-level data on citizenship, perceived health status, body mass index, smoking habits, physical activity and attendance at breast and cervical cancer screening were extracted from the European Health Interview Survey of Eurostat. Data from both sources were obtained for Austria, Bulgaria, Greece, Poland and Spain. The country-specific odds ratio (OR) for the association between the participants’ citizenship and other individual health-relevant characteristics was pooled into summary OR using random-effects models. Meta-regression was used to explore whether the HL of a country could explain part of the between-countries heterogeneity. Results: For the perceived health status, nutritional status and attendance at cervical cancer screening, the lower was the country-level HL (as ecological variable), the higher were the health inequalities relating to citizenship. The results of our exploratory research suggest that improving the population HL may help mitigate health inequalities between residents and migrants. View Full-Text
Keywords: health inequalities; health literacy; immigrant; population health inequalities; health literacy; immigrant; population
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Lorini, C.; Caini, S.; Ierardi, F.; Bachini, L.; Gemmi, F.; Bonaccorsi, G. Health Literacy as a Shared Capacity: Does the Health Literacy of a Country Influence the Health Disparities among Immigrants? Int. J. Environ. Res. Public Health 2020, 17, 1149.

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