Peer-reviewed article
Health literacy among adolescents: summary of some key findings from ten European countries
Paakkari L, Lahti H, Kulmala M, Paakkari O, Lyyra N ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This cross-sectional study examined health literacy levels among 13- and 15-year-old adolescents across ten European countries using data from the Health Behaviour in School-aged Children study. Health literacy was found to be an independent factor that explains health disparities and acts as both a mediator and moderator between background factors and health outcomes such as self-rated health and problematic social media use. The research shows that health literacy had significant effects in all countries, but gender and country-specific differences emerged in how it protects against problems like excessive social media use. The findings suggest that health literacy interventions need to be tailored to specific countries and population groups to promote equity.
Key points
- Health literacy had significant main effects on health outcomes in every country studied
- Gender differences existed: in Finland and Belgium, high health literacy reduced problematic social media use among girls but not boys
- Health literacy mediates and moderates relationships between background factors and health outcomes
- Group-level differences in health literacy emerged only in some countries, not all
- Country-specific and proportionally universal health literacy interventions are needed to avoid widening disparities
Limitations
The cross-sectional design cannot establish causality, only associations. The study does not evaluate the effectiveness of any specific health literacy intervention, so it cannot tell us whether promoting health literacy actually improves outcomes or which intervention approaches work best.
Abstract
Abstract Introduction In research on disparities, the concept of health literacy (HL) as a set of competencies to promote and sustain health may help in understanding the disparities better and in addressing avoidable and unfair health disparities. The presentation will present some key findings on adolescents’ HL levels in ten European countries, and how HL mediates and moderates between various background factors and health outcomes. Methods Data consisted of cross-sectional data from Health Behaviour in School-aged Children (HBSC) study from year 2017/18 of ten European countries (Austria, Belgium (Fl), Czechia, England, Estonia, Finland, Germany, Macedonia, Poland, and Slovakia). Data (n = 14,590 - 22,291) of 13- and 15-year-old pupils were used. Indicators include background variables (e.g. age, gender), Health literacy, Health indicators (e.g. self-rated health (SRH) and problematic social media use (PSMU)). Analysis include (1) Mediator analysis (with Mplus): pearson correlation coefficients, path models (Mplus 7.3 and Maximum Likelihood estimator) and (2) random effects models and moderator analyses (with R-sofware). Findings HL is an independent factor explaining disparities in health (e.g. SRH), and a mediator as well as a moderator between health outcomes and background factors. Based on the national analyses HL had significant main effects in every country, but group level differences emerged only in some countries. For instance, in Finland and Belgium, among girls HL lowered the likelihood to problematic social media use, but not among boys. Discussion HL is of use in understanding and tackling health disparities among adolescents. Results confirm the need to adopt the principles of proportionate universalism when promoting HL among adolescents to avoid widening the disparities within population groups. Also, country-specific health literacy interventions are needed to secure equity in opportunities of different population groups to benefit from the HL interventions.