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Reducing Health Disparities: The Role of Health Literacy and Health Promotion

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 10187

Special Issue Editor

Prof. Dr. Hae-Ra Han

E-Mail Website
Guest Editor
1. Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
2. Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
Interests: chronic care; community; disparities; equity; health behavior; health literacy; public health; social determinants of health

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic has brought the issue of health disparities to the fore. It is widely acknowledged that promoting social justice and equity is crucial in the post-COVID-19 era. Therefore, addressing health disparities has become an even more critical agenda for research and public health. The United Nations emphasized the importance of health literacy for achieving positive health outcomes. They issued a global mandate to advance health literacy for effective health promotion. During a public health crisis like the COVID-19 pandemic, having health literacy is crucial to understanding important public health measures and taking the necessary actions to safeguard public health and save lives. Over the past few decades, health literacy research has predominantly concentrated on individual health literacy, primarily using descriptive study designs. We need more evidence to intervene at various levels using diverse study designs and populations, including those in rural areas. Furthermore, it is necessary to develop new health promotion strategies for vulnerable groups due to the ongoing digital divide among certain segments of society, including older adults and those with limited resources and/or a limited education. We welcome novel research papers of varying study designs, reviews, case reports, and other types of publications, such as methodological papers, brief reports, and commentaries, that include the following keywords.

Prof. Dr. Hae-Ra Han
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health disparities
  • health literacy
  • health promotion
  • community
  • public health
  • health systems
  • social determinants of health
  • under-resourced communities
  • community engagement
  • community action for health
  • health equity

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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22 pages, 727 KiB  
Article
Health Information Use and Trust: The Role of Health Literacy and Patient Activation in a Multilingual European Region
by Christian J. Wiedermann, Verena Barbieri, Stefano Lombardo, Timon Gärtner, Patrick Rina, Klaus Eisendle, Giuliano Piccoliori, Adolf Engl and Dietmar Ausserhofer
Int. J. Environ. Res. Public Health 2025, 22(4), 570; https://doi.org/10.3390/ijerph22040570 - 5 Apr 2025
Viewed by 368
Abstract
The acquisition of reliable health information plays a pivotal role in shaping informed decision-making and health-related behaviours. This investigation examined the factors influencing health information use and trust in health information sources among the adult population in South Tyrol, Italy, employing a population-based [...] Read more.
The acquisition of reliable health information plays a pivotal role in shaping informed decision-making and health-related behaviours. This investigation examined the factors influencing health information use and trust in health information sources among the adult population in South Tyrol, Italy, employing a population-based cross-sectional survey (n = 2090). Descriptive analyses revealed sociodemographic disparities, with younger individuals and those with higher educational attainment demonstrating increased engagement with digital sources, while older adults and those with lower educational levels exhibited a greater reliance on traditional media and healthcare professionals. Correlation analyses showed that elevated health literacy (HLS-EU-Q16) was linked to enhanced engagement with structured and professional health sources, whereas higher patient activation (PAM-10) exhibited a negative correlation with a dependence on healthcare professionals, indicating that more activated individuals are less reliant on medical consultations for health information. Individuals reporting a better health status were less inclined to use health information sources, such as media, healthcare professionals, or the internet, as opposed to relying on personal knowledge or experience. Ordinal regression models further identified age, education, and linguistic background as crucial predictors of health information use and trust in sources. These findings highlight the influence of health literacy and patient activation on information engagement and trust and emphasise the need for tailored public health initiatives to ensure equitable access to reliable health information across diverse demographic groups. Full article
(This article belongs to the Special Issue Reducing Health Disparities: The Role of Health Literacy and Health Promotion)
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13 pages, 275 KiB  
Article
The Role of Formal Schooling, Literacy, and Health Knowledge in Addressing Domestic Violence Against Women in West Africa
by Amelia Van Komen and Hayley Pierce
Int. J. Environ. Res. Public Health 2024, 21(11), 1492; https://doi.org/10.3390/ijerph21111492 - 9 Nov 2024
Viewed by 1290
Abstract
When “education” is cited as a solution for domestic violence, different aspects of knowledge acquisition are often omitted. This study uses 2019 Demographic and Health Surveys from four West African countries (The Gambia, Liberia, Senegal, Sierra Leone) with a combined sample size of [...] Read more.
When “education” is cited as a solution for domestic violence, different aspects of knowledge acquisition are often omitted. This study uses 2019 Demographic and Health Surveys from four West African countries (The Gambia, Liberia, Senegal, Sierra Leone) with a combined sample size of 12,480 women and generalized ordered logit regression to examine the effects of types of knowledge (years of schooling, literacy, and health knowledge) on domestic violence (physical abuse, emotional abuse, and control issues). The results suggest that literacy has the most reliable beneficial impact on domestic violence and was consistently associated with decreased odds of abuse. However, greater findings suggest that schooling, literacy, and health knowledge function as separate types of education and that their relationships are complex and context-specific. By neglecting to see these types of knowledge as separate entities that can operate together, it is possible that mitigation strategies for domestic violence are going undiscovered. Full article
(This article belongs to the Special Issue Reducing Health Disparities: The Role of Health Literacy and Health Promotion)
8 pages, 259 KiB  
Communication
Charting a Path to the Quintuple Aim: Harnessing AI to Address Social Determinants of Health
by Yash B. Shah, Zachary N. Goldberg, Erika D. Harness and David B. Nash
Int. J. Environ. Res. Public Health 2024, 21(6), 718; https://doi.org/10.3390/ijerph21060718 - 31 May 2024
Viewed by 1876
Abstract
The Quintuple Aim seeks to improve healthcare by addressing social determinants of health (SDOHs), which are responsible for 70–80% of medical outcomes. SDOH-related concerns have traditionally been addressed through referrals to social workers and community-based organizations (CBOs), but these pathways have had limited [...] Read more.
The Quintuple Aim seeks to improve healthcare by addressing social determinants of health (SDOHs), which are responsible for 70–80% of medical outcomes. SDOH-related concerns have traditionally been addressed through referrals to social workers and community-based organizations (CBOs), but these pathways have had limited success in connecting patients with resources. Given that health inequity is expected to cost the United States nearly USD 300 billion by 2050, new artificial intelligence (AI) technology may aid providers in addressing SDOH. In this commentary, we present our experience with using ChatGPT to obtain SDOH management recommendations for archetypal patients in Philadelphia, PA. ChatGPT identified relevant SDOH resources and provided contact information for local organizations. Future exploration could improve AI prompts and integrate AI into electronic medical records to provide healthcare providers with real-time SDOH recommendations during appointments. Full article
(This article belongs to the Special Issue Reducing Health Disparities: The Role of Health Literacy and Health Promotion)

Review

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15 pages, 601 KiB  
Review
Risk Factors for Chronic Non-Communicable Diseases of Long-Haul Truck Drivers during the COVID-19 Pandemic: An Integrative Review
by Fernanda Lise, Mona Shattell, Flávia Lise Garcia and Laurel Kincl
Int. J. Environ. Res. Public Health 2024, 21(7), 897; https://doi.org/10.3390/ijerph21070897 - 9 Jul 2024
Cited by 3 | Viewed by 2285
Abstract
Long-haul truck drivers are responsible for transporting goods valued at millions of dollars of the world economy, and may have their health affected by living and working conditions. This study analyzed and synthesized scientific findings about risk factors for the development of chronic [...] Read more.
Long-haul truck drivers are responsible for transporting goods valued at millions of dollars of the world economy, and may have their health affected by living and working conditions. This study analyzed and synthesized scientific findings about risk factors for the development of chronic non-communicable diseases in long-haul truck drivers. An integrative literature review was conducted. We identified 23 studies that met the inclusion criteria and evaluated the health of 7363 drivers. The biological risk factors identified were age, gender, race/ethnicity, genetics, and comorbidities, and were considered to be non-modifiable for chronic diseases. The behavioral risks considered to be modifiable were sedentary lifestyle, smoking, alcohol consumption, overweight, diet, stress, anxiety, and unfavorable socioeconomic conditions. Environmental risks involved working conditions such as the following: number of working hours per day, week, and month; time away from home; risk of musculoskeletal injury; and opportunities for rest, hours of sleep, and access to health services. The results were presented in two categories: (1) biological, behavioral, and environmental risks, and (2) general recommendations to promote physical, cognitive, and emotional health. Macro-structural changes are needed to reorganize work and rest, improve access to health services to control modifiable risk factors, and to support behavioral and environmental changes to reduce chronic non-communicable diseases and deaths. Full article
(This article belongs to the Special Issue Reducing Health Disparities: The Role of Health Literacy and Health Promotion)
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Other

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36 pages, 616 KiB  
Systematic Review
The Role of Health Information Sources on Cervical Cancer Literacy, Knowledge, Attitudes and Screening Practices in Sub-Saharan African Women: A Systematic Review
by Joyline Chepkorir, Dominique Guillaume, Jennifer Lee, Brenice Duroseau, Zhixin Xia, Susan Wyche, Jean Anderson and Hae-Ra Han
Int. J. Environ. Res. Public Health 2024, 21(7), 872; https://doi.org/10.3390/ijerph21070872 - 3 Jul 2024
Cited by 3 | Viewed by 3287
Abstract
Cervical cancer is the leading cause of cancer deaths among Sub-Saharan African women. This systematic review aimed to identify information sources and their relation to cervical cancer knowledge, literacy, screening, and attitudes. Peer-reviewed literature was searched on 2 March 2022, and updated on [...] Read more.
Cervical cancer is the leading cause of cancer deaths among Sub-Saharan African women. This systematic review aimed to identify information sources and their relation to cervical cancer knowledge, literacy, screening, and attitudes. Peer-reviewed literature was searched on 2 March 2022, and updated on 24 January 2023, in four databases—CINAHL Plus, Embase, PubMed, and Web of Science. Eligible studies included those that were empirical, published after 2002, included rural women, and reported on information sources and preferences. The quality of the selected articles was assessed using the Mixed Methods Appraisal Tool. Data extraction was conducted on an Excel spreadsheet, and a narrative synthesis was used to summarize findings from 33 studies. Healthcare workers were the most cited information sources, followed by mass media, social networks, print media, churches, community leaders, the Internet, and teachers. Community leaders were preferred, while healthcare workers were the most credible sources among rural women. There was generally low cervical cancer knowledge, literacy, and screening uptake, yet high prevalence of negative attitudes toward cervical cancer and its screening; these outcomes were worse in rural areas. A content analysis revealed a positive association of health information sources with cervical cancer literacy, knowledge, screening, and positive screening attitudes. Disparities in cervical cancer prevention exist between rural and urban Sub-Saharan African women. Full article
(This article belongs to the Special Issue Reducing Health Disparities: The Role of Health Literacy and Health Promotion)
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