Health Literacy among Older Adults: A Descriptive Cross-sectional Analysis in Vietnam

Document Type : Original Article

Authors

1 Dong A University, Danang 550000, Vietnam

2 Nam Dinh University of Nursing, Namdinh 420000, Vietnam.

3 Da Nang University of Medical Technology and Pharmacy, Danang 550000, Vietnam.

Abstract

Background and Objectives: Adequate Health Literacy is particularly important for older adults, who often face complex healthcare needs. The objective of this study was to evaluate the Health Literacy levels of older adults in Da Nang city, located in central Vietnam.

Material and Methods: A cross-sectional study was conducted involving 204 Vietnamese older adults living in Da Nang City, using convenience sampling. Health Literacy was measured using a validated Vietnamese version of the Short-Form Health Literacy Questionnaire, which evaluates four dimensions: healthcare, disease prevention, health promotion, and general Health Literacy. Statistical analysis was performed using multiple logistic regression, with variables achieving a p-value below 0.05 considered statistically significant.

Results:  Overall, 60.3% of participants exhibited inadequate general Health Literacy, while only 39.7% demonstrated sufficient levels. Urban residents had 2.4 times higher Health Literacy levels than rural counterparts (AOR= 2.4, 95% CI: 1.06-5.44). Education was a strong determinant, with participants who completed secondary-high school (AOR= 3.35, 95% CI: 1.42-7.91) and upper high school (AOR= 7.75, 95% CI: 2.84-21.11) showing higher Health Literacy compared to those with primary or lower education.

Conclusion: This study provides valuable insights into the Health Literacy levels of Vietnamese older adults in central Vietnam. The findings underscore the urgent need for health education programs to enhance Health Literacy, particularly targeting rural populations and individuals with low educational attainment. 

Keywords

Acknowledgments: The authors would like to express their sincere appreciation to Dong A University for financially supporting this research. We are also grateful to all participants who contributed to this study, as their involvement was essential for the successful completion of our research.


Availability of data and materials: All data analyzed during this study is available from the corresponding author upon reasonable request.


Conflict of interest: There is no known conflict of interest to declare.

 
Consent for publication: Not applicable.


Ethics approval and consent to participate: This study received approval from the Dong A University Science Committee under reference number 1523/QĐ-ĐHĐA-QLKH on August 5th, 2023. Prior to conducting the survey, the study's objectives were explained, and verbal consent was obtained from all participants. The study was conducted following the principles of the Declaration of Helsinki.


Funding: This research was funded by Dong A University. We acknowledge the university's commitment to advancing research in this field and its role in supporting academic endeavors.


Authors’ contribution: Tran Thi My: Led the research project, designed the study, assisted in data collection and interpretation, manuscript writing and revision. Lai Thi Ha: Contributed to the data collection and responsible for data analysis. Vo Le Thanh Thuy, Hoang Thi Hien, Nguyen Thi Ngoc Trinh, Do Thi Thuy Minh, Tran Cong Huyen Trang, Mai Thi Bich Huyen: Contributed to the data collection. Vu Thi Thanh Hang, Nguyen Thi Thu Trieu: Contributed to the literature review, provided expertise in methodology.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

References

  1. Simonds SK. Health Education as Social Policy. Health Educ Monogr. 1974 Mar 1;2(1_suppl):1-10. https://doi.org/10.1177/10901981740020S102
  2. Claeson M, Folger P. Health Issues of the UN Millennium Development Goals. In: International Encyclopedia of Public Health [Internet]. Elsevier; 2008 [cited 2023 Jan 13]. p. 197-204. https://doi.org/10.1016/B978-012373960-5.00633-X
  3. Santana S, Brach C, Harris L, Ochiai E, Blakey C, Bevington F, et al. Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health. J Public Health Manag Pract. 2021 Dec;27(Supplement 6):S258. https://doi.org/10.1097/PHH.0000000000001324 PMid:33729194 PMCid:PMC8435055
  4. Centers for Disease Control and Prevention. Older Adults | Health Literacy | CDC [Internet]. 2021 [cited 2024 Jun 30]. Available from: https://www.cdc.gov/healthliteracy/developmaterials/audiences/olderadults/index.html
  5. UNFPA Vietnam. UNFPA Vietnam. [cited 2025 Jan 8]. The Population And Housing Census 2019: Population Ageing and Older Persons in Viet Nam. Available from: https://vietnam.unfpa.org/en/publications/population-and-housing-census-2019-population-ageing-and-older-persons-viet-nam
  6. DA NANG Today. DaNangEnglish. 2024 [cited 2025 Jan 4]. Da Nang's market potential of elderly service industry. Available from: http://baodanang.vn/english/E-Magazine/202412/da-nangs-market-potential-of-elderly-service-industry-3998631/
  7. Relationship between diabetes health literacy, distress, burnout, social support, complications, self-care behaviors, and quality of life among patients with type 2 diabetes: a path analysis study.
  8. Geboers B, Uiters E, Reijneveld SA, Jansen CJM, Almansa J, Nooyens ACJ, et al. Health literacy among older adults is associated with their 10-years' cognitive functioning and decline - the Doetinchem Cohort Study. BMC Geriatr. 2018 Mar 20;18(1):77. https://doi.org/10.1186/s12877-018-0766-7 PMid:29558890 PMCid:PMC5859753
  9. Shahid R, Shoker M, Chu LM, Frehlick R, Ward H, Pahwa P. Impact of low health literacy on patients' health outcomes: a multicenter cohort study. BMC Health Serv Res. 2022 Sep 12;22(1):1148. https://doi.org/10.1186/s12913-022-08527-9 PMid:36096793 PMCid:PMC9465902
  10. MacLeod S, Musich S, Gulyas S, Cheng Y, Tkatch R, Cempellin D, et al. The impact of Health Literacy on health outcomes among older adults. Innov Aging. 2017 Jul 1;1:833-4. https://doi.org/10.1093/geroni/igx004.3004 PMCid:PMC6184663
  11. Lu J, Sun S, Gu Y, Li H, Fang L, Zhu X, et al. Health literacy and health outcomes among older patients suffering from chronic diseases: A moderated mediation model. Front Public Health. https://doi.org/10.3389/fpubh.2022.1069174 PMid:36703841 PMCid:PMC9873261
  12. Lima ACP, Maximiano-Barreto MA, Martins TCR, Luchesi BM. Factors associated with poor health literacy in older adults: A systematic review. Geriatr Nur (Lond). 2024 Jan 1;55:242-54. https://doi.org/10.1016/j.gerinurse.2023.11.016 PMid:38070263
  13. Van Hoa H, Giang HT, Vu PT, Van Tuyen D, Khue PM. Factors Associated with Health Literacy among the Elderly People in Vietnam. BioMed Res Int. https://doi.org/10.1155/2020/3490635 PMid:32309429 PMCid:PMC7139882
  14. Tiller D, Herzog B, Kluttig A, Haerting J. Health literacy in an urban elderly East-German population - results from the population-based CARLA study. BMC Public Health. 2015 Sep 10;15:883. https://doi.org/10.1186/s12889-015-2210-7 PMid:26357978 PMCid:PMC4566302
  15. Cuong TQ, Quyen NH, Tot TV, Tram VTM, Nguyen PTT, Tuyen DV, et al. Health Literacy in older adults and its related factors. 第六屆亞洲健康識能國際會議 [Internet]. 2018 Oct 24 [cited 2024 Jul 24]; Available from: https://www.airitilibrary.com/Article/Detail/P20181023002-201810-PP201810230001-PP201810230001-1-3-067
  16. Tiller D, Herzog B, Kluttig A, Haerting J. Health literacy in an urban elderly East-German population - results from the population-based CARLA study. BMC Public Health. 2015 Sep 10;15:883. https://doi.org/10.1186/s12889-015-2210-7 PMid:26357978 PMCid:PMC4566302
  17. Smith SG, O'Conor R, Curtis LM, Waite K, Deary IJ, Paasche-Orlow M, et al. Low health literacy predicts decline in physical function among older adults: findings from the LitCog cohort study. J Epidemiol Community Health. 2015 May 1;69(5):474-80. https://doi.org/10.1136/jech-2014-204915 PMid:25573701 PMCid:PMC4413744
  18. Meppelink CS, Smit EG, Buurman BM, van Weert JCM. Should We Be Afraid of Simple Messages? The Effects of Text Difficulty and Illustrations in People With Low or High Health Literacy. Health Commun. 2015;30(12):1181-9. https://doi.org/10.1080/10410236.2015.1037425 PMid:26372031
  19. Meppelink CS, Weert JC van, Haven CJ, Smit EG. The Effectiveness of Health Animations in Audiences With Different Health Literacy Levels: An Experimental Study. J Med Internet Res. https://doi.org/10.2196/jmir.3979 PMid:25586711 PMCid:PMC4319081
  20. Bánfai-Csonka H, Bánfai B, Jeges S, Gyebnár B, Betlehem J. Health literacy among participants from neighbourhoods with different socio-economic statuses in the southern region of Hungary: a pilot study. BMC Public Health. 2020 Aug 17;20(1):1060. https://doi.org/10.1186/s12889-020-08959-0 PMid:32799828 PMCid:PMC7429903
  21. Kesic MG, Peric M, Gilic B, Manojlovic M, Drid P, Modric T, et al. Are Health Literacy and Physical Literacy Independent Concepts? A Gender-Stratified Analysis in Medical School Students from Croatia. Children. https://doi.org/10.3390/children9081231 PMid:36010123 PMCid:PMC9406589
  22. Yunus R, Mohd S, Saman, Zubillah A, Juni K, Gaairibi A, et al. Health Literacy Among Urban Malaysian Elders: A Descriptive Study. ASM Sci J. 2020 Apr 1;7-12.
  23. Suppiah SD, Malhotra R, Tan YW, Jessup RL, Chew LST, Tang WE, et al. Prevalence of health literacy and its correlates from a national survey of older adults. Res Soc Adm Pharm. 2023 Jun 1;19(6):906-12. https://doi.org/10.1016/j.sapharm.2023.02.013 PMid:36898905
  24. Ruangkiatkul N. ปัจจัยที่สัมพันธ์กับความรอบรู้ด้านสุขภาพของผู้สูงอายุไทย. J Dep Med Serv. 2022 Mar 31;47(1):80-6.
  25. Meier C, Vilpert S, Borrat-Besson C, Jox RJ, Maurer J. Health literacy among older adults in Switzerland: cross-sectional evidence from a nationally representative population-based observational study. Swiss Med Wkly. https://doi.org/10.4414/SMW.2022.w30158 PMid:35429235
  26. Eronen J, Paakkari L, Portegijs E, Saajanaho M, Rantanen T. Assessment of health literacy among older Finns. Aging Clin Exp Res. 2019 Apr 1;31(4):549-56. https://doi.org/10.1007/s40520-018-1104-9 PMid:30578457 PMCid:PMC6439255
  27. Li S, Wang J, Ren L, Ye P, Niu W, Yu M, et al. Health literacy and falls among community-dwelling older people in China: is there a sex difference? Aging Clin Exp Res. 2024 Jul 18;36(1):148. https://doi.org/10.1007/s40520-024-02788-6 PMid:39023697 PMCid:PMC11258050
  28. Aljassim N, Ostini R. Health literacy in rural and urban populations: A systematic review. Patient Educ Couns. 2020 Oct 1;103(10):2142-54. https://doi.org/10.1016/j.pec.2020.06.007 PMid:32601042
  29. Wu S sheng, Yang P, Li H yue, Ma C na, Zhang Y, Wang Q yi. [Analysis of status and influence factors of health literacy related to infectious diseases in residents of Beijing]. Beijing Da Xue Xue Bao. 2012 Aug 18;44(4):607-11.
  30. Eberhardt MS, Pamuk ER. The Importance of Place of Residence: Examining Health in Rural and Nonrural Areas. Am J Public Health. https://doi.org/10.2105/AJPH.94.10.1682 PMid:15451731 PMCid:PMC1448515
  31. Tao S, Sun S, Wu S, Peng T, Cao L, Yan M, et al. Current status and influencing factors of health literacy among older adults in combined medical and nursing care institutions: a cross-sectional study. Front Public Health. https://doi.org/10.3389/fpubh.2023.1323335 PMid:38292383 PMCid:PMC10825950

Files

Share

How to cite

Statistics