Health literacy and chronic disease: a comparison of somatic and mental illness
Bibliographic record
Abstract
Background: Health literacy (HL) is increasingly recognized as essential for preventing and managing chronic illness but also for strengthening health resources and skills. However, studies on HL of people with chronic illness that adopt a multidimensional approach encompassing the three HL domains health care, disease prevention, and health promotion, remain scarce. This study aims to (a) compare HL across these three domains in individuals with chronic somatic illness, chronic mental illness and those without any chronic illness, (b) to explore where difficulties in managing health-related information occur and how these differ between groups, and (c) to analyze the relationship between demographic, social, and psychological factors and HL. Methods: Data from a quantitative cross-sectional survey in Germany were stratified according to respondents with at least one chronic somatic illness, at least one chronic mental illness and without chronic illness. The survey was conducted by means of paper-assisted personal interviews. HL was measured in three domains health care, disease prevention and health promotion. Age, educational level, social status, financial resources, number of chronic illnesses, social support, and self-efficacy were included in the analysis as potential determinants of HL. Differences between groups were analyzed using bivariate statistics; multiple linear regressions were calculated to examine relationships between potential determinants and HL. Results: Respondents with chronic mental illness showed lowest HL, followed by those with chronic somatic illness. Respondents without chronic illness achieved highest HL. This pattern was consistent across all three HL domains. Among all groups, HL was lowest in the domain of health promotion. Notable differences emerged in perceived difficulties, with respondents with mental illnesses reporting the most significant challenges. Self-efficacy and education level showed a positive association with HL across all groups, while social support was positively associated with HL among individuals with chronic mental illness. For respondents with chronic somatic illness, age was negatively associated with HL, whereas social status showed a positive association. Female respondents without chronic illness and those with chronic somatic illness demonstrated higher HL compared to male respondents. Conclusion: This study advances the understanding of HL among individuals with chronic illness and highlights the need for a greater differentiation among disease groups and HL domains in future research. Particular attention should be paid to people with chronic mental illness, whose lower HL levels increase their vulnerability.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".