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Relationship between Determinants of Health, Equity, and Dimensions of Health Literacy in Patients with Cardiovascular Disease

Cabellos-García, A. C., Castro-Sanchez, E. ORCID: 0000-0002-3351-9496, Martínez-Sabater, A. , Díaz-Herrera, M. A., Ocaña-Ortiz, A., Juárez-Vela, R. & Gea-Caballero, V. (2020). Relationship between Determinants of Health, Equity, and Dimensions of Health Literacy in Patients with Cardiovascular Disease. International Journal of Environmental Research and Public Health, 17(6), 2082. doi: 10.3390/ijerph17062082


Background: Health literacy (HL) has been linked to empowerment, use of health services, and equity. Evaluating HL in people with cardiovascular health problems would facilitate the development of suitable health strategies care and reduce inequity.

Aim: To investigate the relationship between different dimensions that make up HL and social determinants in patients with cardiovascular disease.

Methods: Observational, descriptive, cross-sectional study in patients with cardiovascular disease, aged 50-85 years, accessing primary care services in Valencia (Spain) in 2018-2019. The Health Literacy Questionnaire was used.

Results: 252 patients. Age was significantly related with the ability to participate with healthcare providers (p = 0.043), ability to find information (p = 0.022), and understanding information correctly to know what to do (p = 0.046). Level of education was significant for all HL dimensions. Patients without studies scored lower in all dimensions. The low- versus middle-class social relationship showed significant results in all dimensions.

Conclusions: In patients with cardiovascular disease, level of education and social class were social determinants associated with HL scores. Whilst interventions at individual level might address some HL deficits, inequities in access to cardiovascular care and health outcomes would remain unjustly balanced unless structural determinants of HL are taken into account.

Publication Type: Article
Additional Information: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: cardiovascular diseases; equity; health literacy; health status disparities; social determinants of health
Subjects: H Social Sciences > HM Sociology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine
Departments: School of Health & Psychological Sciences > Nursing
Text - Published Version
Available under License Creative Commons: Attribution International Public License 4.0.

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