Association between health literacy and mortality: a systematic review and meta-analysis

Abstract Background To identify the relationship between health literacy (HL) and mortality based on a systematic review and meta-analysis. Methods Literature published from database inception until July 2020 was searched using the PubMed and Web of Science databases, using relevant keywords and cle...

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Main Authors: Zhao-ya Fan, Yuan Yang, Fan Zhang
Format: Article
Language:English
Published: BMC 2021-07-01
Series:Archives of Public Health
Subjects:
Online Access:https://doi.org/10.1186/s13690-021-00648-7
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author Zhao-ya Fan
Yuan Yang
Fan Zhang
author_facet Zhao-ya Fan
Yuan Yang
Fan Zhang
author_sort Zhao-ya Fan
collection DOAJ
description Abstract Background To identify the relationship between health literacy (HL) and mortality based on a systematic review and meta-analysis. Methods Literature published from database inception until July 2020 was searched using the PubMed and Web of Science databases, using relevant keywords and clear inclusion and exclusion criteria. The search was limited to English language articles. Two reviewers independently selected studies and extracted data. Pooled correlation coefficients and their 95% confidence intervals (CI) between HL and mortality were estimated using Stata 15.0 software. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis, and meta-regression. Quality of the original studies that were included in the meta-analysis was evaluated using the Newcastle–Ottawa Scale. A funnel plot and Egger’s test were used to determine whether significant publication bias was present. Results Overall, 19 articles were included, reporting on a total of 41,149 subjects. Eleven were prospective cohort studies, and all articles were considered “good” quality. The most used screening instruments were the short Test of Functional Health Literacy (S-TOFHLA) in Adults and the Brief Health Literacy Screen (BHLS). Among 39,423 subjects (two articles did not report the number of patients with low HL), approximately 9202 (23%) had inadequate or marginal HL. The correlation coefficient between HL and mortality was 1.25 (95%CI = 0.25–0.44). Conclusion Lower HL was associated with an increased risk of death. This finding should be considered carefully and confirmed by further research.
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spelling doaj.art-f2490e18a4214c6084cd3aabc3defa852022-12-21T22:06:55ZengBMCArchives of Public Health2049-32582021-07-0179111310.1186/s13690-021-00648-7Association between health literacy and mortality: a systematic review and meta-analysisZhao-ya Fan0Yuan Yang1Fan Zhang2School of Public Health and Management, Chongqing Medical UniversityDepartment of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical UniversitySchool of Public Health and Management, Chongqing Medical UniversityAbstract Background To identify the relationship between health literacy (HL) and mortality based on a systematic review and meta-analysis. Methods Literature published from database inception until July 2020 was searched using the PubMed and Web of Science databases, using relevant keywords and clear inclusion and exclusion criteria. The search was limited to English language articles. Two reviewers independently selected studies and extracted data. Pooled correlation coefficients and their 95% confidence intervals (CI) between HL and mortality were estimated using Stata 15.0 software. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis, and meta-regression. Quality of the original studies that were included in the meta-analysis was evaluated using the Newcastle–Ottawa Scale. A funnel plot and Egger’s test were used to determine whether significant publication bias was present. Results Overall, 19 articles were included, reporting on a total of 41,149 subjects. Eleven were prospective cohort studies, and all articles were considered “good” quality. The most used screening instruments were the short Test of Functional Health Literacy (S-TOFHLA) in Adults and the Brief Health Literacy Screen (BHLS). Among 39,423 subjects (two articles did not report the number of patients with low HL), approximately 9202 (23%) had inadequate or marginal HL. The correlation coefficient between HL and mortality was 1.25 (95%CI = 0.25–0.44). Conclusion Lower HL was associated with an increased risk of death. This finding should be considered carefully and confirmed by further research.https://doi.org/10.1186/s13690-021-00648-7Health literacyMortalityCorrelation coefficientMeta-analysis
spellingShingle Zhao-ya Fan
Yuan Yang
Fan Zhang
Association between health literacy and mortality: a systematic review and meta-analysis
Archives of Public Health
Health literacy
Mortality
Correlation coefficient
Meta-analysis
title Association between health literacy and mortality: a systematic review and meta-analysis
title_full Association between health literacy and mortality: a systematic review and meta-analysis
title_fullStr Association between health literacy and mortality: a systematic review and meta-analysis
title_full_unstemmed Association between health literacy and mortality: a systematic review and meta-analysis
title_short Association between health literacy and mortality: a systematic review and meta-analysis
title_sort association between health literacy and mortality a systematic review and meta analysis
topic Health literacy
Mortality
Correlation coefficient
Meta-analysis
url https://doi.org/10.1186/s13690-021-00648-7
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