ABSTRACT
BACKGROUND: People with disabilities and chronic diseases represent a population group in vulnerable circumstances, and often have difficulty finding, understanding, assessing, and applying health information. The aim of this study was to examine the health literacy of people doubly burdened with both disabilities and chronic diseases in comparison to two other groups, namely people with either disabilities or chronic diseases and people without impairment. MATERIAL AND METHODS: Our data is based on the representative survey "German Health Update" 2014/2015-EHIS. The sample consists of n=21,647 people, including 2,875 (13.3%) people with disabilities and chronic diseases, 7,598 people (35.1%) with disability or chronic diseases and 11,174 (51.6%) people without impairment. Health literacy was measured using the short form of the questionnaire of the European Health Literacy Survey (HLS-EU-Q16). Uni, bi- and multivariate analyses were conducted. RESULTS: 43.7% of respondents with both disabilities and chronic diseases had quite a lot difficulties in dealing with health information in comparison to people with disabilities or chronic diseases (37.7%) or those with no impairment (33.0%). People with double burdens had a 1.22-fold (CI: 1.10-1.35; p<0.001) and people with a single burden had a 1.08-fold (CI: 1.01-1.16; p=0.031) increased likelihood to find it difficult or very difficult to find, understand, evaluate and apply health-related information compared to people without impairment. CONCLUSION: The results show a gradient to the disadvantage of people with disabilities and/or chronic diseases. Health literacy among people with disabilities and/or chronic diseases should be adequately promoted in order to support their health, their participation as well as the quality and efficiency of and the reduction of barriers to access health care.
Subject(s)
Disabled Persons , Health Literacy , Humans , Germany/epidemiology , Surveys and Questionnaires , Chronic DiseaseABSTRACT
PURPOSE: People with disabilities belong to a vulnerable population group, especially with regard to their economic and health situation. In the social-epidemiological research, hardly any studies on mental health and health awareness among people with disabilities are available using representative data, in particular not differentiated according to their degree of disability (DoD). Therefore, the aim of this study is to investigate 1) differences in mental health and health awareness between people with disabilities compared to people without disabilities. In addition, the study 2) shows differences mental health outcomes and health awareness, differentiated according to the DoD. METHODS: Data is used from the representative study "Gesundheit in Deutschland Aktuell (GEDA) 2012" (N=19,294). Outcomes were self-reported health, health awareness, depression or depressive mood, mental discomfort, vitality and psychological well-being. The exposure variable used was the recognized disability (DoD≥50 vs. DoD<50 vs. no disability). Univariate and bivariate analyses were conducted using cross-tables and multivariate analyses using binary logistic regression models, controlled for socio-demographic, economic and health-related features. RESULTS: People with disabilities often rate their mental health worse than people without disabilities. The bi- and multivariate analyses revealed a disability-specific gradient for all outcome measures according to the DoD (p<0,001). People with disabilities had a significantly higher likelihood of poor mental health compared to people without disabilities. People with severe disabilities (DoD≥50) had a more than 4,6-fold increased likelihood risk of poor self-reported health and 2,5-fold likelihood of depression or depressed mood compared to people without disabilities. A high level of health awareness was more prevalent in PWD than in those without disabilities. CONCLUSION: The study highlights that People with disabilities more frequently reported mental health problems than people without disabilities. Targeted measures are necessary, which address in particular the target group of the people with disabilities. There is further need to strengthen access to health services and programs, assistive technologies and support services, and to make health of people with disabilities to the subject of research and health promotion in line with the WHO Action Plan on "Better health for all people with disabilities" (2014-2021).
Subject(s)
Consciousness , Disabled Persons/psychology , Mental Health , Germany , Humans , Surveys and QuestionnairesABSTRACT
To date, studies on individual and organizational health literacy (OHL) in facilities for people with disabilities are scarce. Thus, the aims of this study are (1) to adapt an existing instrument for measuring organizational health literacy (OHL), namely, the "Health literate health care organization scale" (HLHO-10), to the context of facilities for people with disabilities, (2) to quantitatively examine characteristics of OHL, and (3) to qualitatively assess the definition and role of OHL by interviewing managers and skilled staff. An online study in Germany with N = 130 managers and skilled staff in facilities for people with disabilities was conducted, using the adapted HLHO-10 questionnaire. Univariate analyses were applied. Qualitative content analysis was used to investigate interview data from N = 8 managers and skilled staff from N = 8 facilities for people with disabilities in Hesse, Germany. Quantitative results revealed that respondents reported a below-average level in HLHO-10, with the lowest level found in the attribute of participative development of health information. The qualitative findings showed a clear need for improved navigation to and in facilities. The quantitative and qualitative findings are mainly consistent. Future research and measures should focus on facilities for people with disabilities in order to strengthen the development of and access to target-group-specific health information, as well as to establish a health-literate working and living environment.
